FRABA - REGISTRATION

Membership Application Form

Business Name *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Mailing Address (if different from above)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

FRABA members are required to operate a business in the area or be a local resident. If your business is not located in the Fall River area please provide home address showing you are a resident.

Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Business Phone Number *

Area Code Phone Number

Contact Name *

First Name Last Name

Cell Phone Number *

Area Code Phone Number

E-mail *

Web Site

Face Book

Twitter:

Alternate Contact

First Name Last Name

Alternate Direct Phone Number

Area Code Phone Number

E-mail

Face Book

Twitter:

Give a short description of what your business is about. If no changes are required you may leave this section blank.

Business Description *

No. of Employees:

How Did You Hear About US

The Laker other Advertising FRABA Flyer

Other

Referred by:

Fees

• Business $75.00 (1 vote)

• Additional Company Listings $35.00 (no vote)/ fill out 2nd application

• Non-Profit Organizations/Associate members $35.00 (no voting privilege)

PAYMENT INSTRUCTIONS WILL BE PROVIDED ONCE YOUR APPLICATION HAD BEEN APPROVED

I submit this application for full FRABA membership with all rights, privileges and benefits. I understand the information I provide may be published or given out as part of the FRABA's services to its members and public. I understand and agree to be goverened by the present and future by-laws of the Association.