Higgins - BNI Accelerated Membership Form

Select Application Type*

Click Here For Renewal Site

Your Name*

First NameLast Name

Your Mobile Number*

Area CodePhone Number

Your Email*

example@example.com

Business Type

Business Name*

Corporation / Legal Name for Check*

Corporate / Personal Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Chapter Choice (If Known)

BNI NW-Florida takes care of the application and membership fee for one (1) non-profit in each chapter for the first 12 months.

Name of the previous member with remaining COC*

First NameLast Name

Name of previous chapter (if known)

For Check Payments

Please make out check to: BNI OF NORTHWEST FLORIDA

Then send it to: 1111 E TENNESSEE ST, Tallahassee, FL 32308

Check amounts:

1-Year Membership - $929 ($230 Application Fee + $699 Annual Membership)

2-Year Membership - $1,549 ($230 Application Fee + $1319 Annual Membership)

5-Year Membership - $3,029 ($230 Application Fee + $2799 Annual Membership)

My Products

1-Year Membership$929.00

$230 Application Fee + $699 Annual Membership

1-Year Membership Pay Option$245.00

4 Monthly Payments of $245

2-Year Membership$1,549.00

$230 Application Fee + $1319 Annual Membership ($79 Savings)

2-Year Membership Pay Option$265.00

6 Monthly Payments of $265

5-Year Membership$3,029.00

$230 Application Fee + $2799 Annual Membership ($696 Savings)

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Once approved, the BNI Regional Office would like to send you a welcome gift and your BNI member name badge. Please provide us with the best shipping address.

Same as Billing*

YesNo

Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name on Badge*

First NameLast Name

The Membership Committee may check two business references that can vouch for your business excellence.
Please enter two business references that know you or your business.

Reference 1 Name*

First NameLast Name

Reference 1 Email*

example@example.com

Reference 2 Name*

First NameLast Name

Reference 2 Email*

example@example.com

Please let your references know that they will receive a simple form to fill out on your behalf via email.

Have you opted to spread the membership payments (pay option)?*

YesNo

By SIGNING THIS AGREEMENT, I agree to terms & conditions.
(A) This is an optional installment payment program offered in good faith to you and is not provided through BNI and/or its affiliates. As such, you agree to hold BNI OF NORTHWEST FLORIDA dba BNI NW Florida and its representatives harmless, for any damages that may result as part of processing payments under this program. BNI OF NORTHWEST FLORIDA, is authorized to bill your bank/charge account for the above payment plan. You/Payor are authorized to sign/pay via the payment method selected and accept all liability and responsibility for agreed to payments under this program. You assume responsibility for informing the BNI Regional Office of any changes to the payment account prior to the monthly payment date selected above.
(B) BNI fees are non-refundable without exception per the BNI Membership Agreements once the membership application is accepted by the chapter’s membership committee. Payor is responsible for all payments regardless of member resignation or termination from the chapter or payor’s employment. We reserve the right to collect the full balance due if the member leaves BNI. Membership is based on a one or two-year commitment per the BNI option you select, regardless of payment option selected. Membership transfers are not permitted unless balance is paid off in full (including incurred fees).
(C) Any fees incurred as a result of processing these payments due to charges from your financial institution will be processed when incurred. Failed installment payments will be assessed a $10 service fee. Payments not made by the 1st of the month will be considered late and incur a $25 per month late payment fee; payments later than 45 days will result in termination of membership unless all incurred fees and balance due are paid in full within 7 days of final notice.
(D) The Easy Pay options include a monthly service fee, which is included as part of each processed monthly payment. Payments are to be made by electronic funds transfer (EFT/ACH) via the bank account associated with the check provided for the initial payment or charged to the charge account provided via the online link provided by the regional office. Unless otherwise notified in writing, all transactions will be processed on/about the 10th of the month. There is no prepayment penalty. To pay off the balance due, including incurred fees, you will need to contact the regional office to determine current payoff balance.

Signature*

After submission, you will be automatically be forwarded to select a chapter and the membership application page.

BNI APPLICATION

Click Here For Renewal Site

MEMBERSHIP PAYMENT

SHIPPING

BUSINESS REFERENCE CHECK

Agreement