First Name
Last Name
Company Name
Business Address (this address will be published publicly)
City
State
Zip
Is your business location a commercial one that a customer can walk into to conduct business? Or are you "mobile only," going to their location by appointment? Or both?
Commercial WalkIn Location Mobile Only Both Home Based
Business Phone
Business Cell
Business Email
Please re-enter your email
Business Website
Please write a few words about your business to be inserted in the printed Member Directory Brochure, website, etc. Make it like a short advertisement as it will be distributed to the public. Your description is limited to about 100 characters, including punctuation and spaces. We may edit or make changes to fit our format.
List professional licenses/certificates
City/local business license numbers and/or locale (i.e. Los Angeles, nationwide, etc.)
Year Business Started
Do you have a valid State Resale License?
List your other business affiliations, networking groups, etc.
PERSONAL INFORMATION (required information - will be kept confidential)
Personal Cell
Emergency Contact / Phone #
Social media info (i.e. Facebook, Instagram, etc.)
Who were you referred by?
Your Birthday month/day
Acknowledgement:
I understand that if accepted for membership, I may resign at any time without notice, or that my membership may be terminated at any time by the Board. I also acknowledge that I have clicked on this link and have read, understand, and agree to abide by the “Rules & Guidelines” of Networking Plus. This acceptance also allows Networking Plus to contact me by email, text, phone, or other means with information about the group.
Please type your signature below
Send
