Member Application
Please provide all required details
Applicant Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Contact Number
*
Business Name
*
DBA (if applicable)
FEIN
Type of business registered with MN Secretary of State
Please Select
Sole Proprietorship
Partnership
LLC
C corp
S corp
B corp
Nonprofit
Other
Requested Member Level
Virtual Member
Premium Co-work (Drop-in Desk)
Dedicated Desk
Office Suite
Last year annual revenue
This year projected annual revenue
Number of total employees and/or contractors (including self)
Number of employees and/or contractors on-site (including self)
Current Business Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Others
*
Description of Business
Message
All membership levels include the base virtual membership of $50/month - would you like to start your membership immediately?
Yes
No
Authorization to perform background check (disclaimer or required legal statement)
Yes
No
Name
First Name
Last Name
Date
-
Month
-
Day
Year
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Signature of Authorized Officer
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