SCWIB Women In Business Membership Application

Application for Membership

Please complete all questions in their entirety for consideration of membership into Southern Crescent Women In Business Inc.
South Metro Chapter of Southern Crescent Women In BusinessNorth Metro Chapter of Southern Crescent Women In BusinessFloridaOther StateGen Z, Under Age 26Other
Name

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Business Name
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business E-mail
Business Number

Area CodePhone Number
Cellular Number

Area CodePhone Number
Business Industry
Please list any Boards that you serve on or have been appointed to? Please list them and what your role is.
Social Media Handles
Business Website
What do you hope to achieve by being a part of Southern Crescent Women In Business Inc.?
Do you believe in supporting other women in business? Why?
Would you like to offer your fellow members a discount on your business product and/or service? If so what is the percentage or dollar amount?
What type of assistance or support do you need from Southern Crescent Women In Business Inc.?
Do you need a Business Mentor?
Would you like to be a Business Mentor?
Would you be interested in being a mentor to a young professional woman, i.e. college age, etc?
Would you be interested in offering a young professional woman an internship?
Do you understand that Southern Crescent Women In Business Inc is more than a networking organization?
What additional information would you like us to know and consider?
Please provide your logo

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If you were referred by someone, please list their name.
Signature*
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New: Required Application Fee for New Applicants. Non-Refundable Processing Fee.

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Application for Membership