Apply Now to Become a Member of The NSLBA
You’re making the right decision by becoming a member of the NSLBA
Estás tomando la decisión correcta al hacerte miembro de la NSLBA
“Engaged to Progress – Comprometidos al Progreso”
NEW MEMBER / NUEVO MIEMBRO
NEW MEMBER / NUEVO MIEMBRO
RENEW / RENOVACION
RENEW / RENOVACION
DATE / FECHA
BUSINESS NAME / NOMBRE DE NEGOCIO
BUSINESS ADDRESS / DIRECCION DE NEGOCIO
BUSINESS ADDRESS
CITY/CIUDAD
STATE/ESTADO ZIP
CODE/CODIGO POSTAL
BUSINESS TELEPHONE
BUSINESS WEBSITE
PRIMARY CONTACT PERSON / PERSONA DE CONTACTO PRINCIPAL
NAME/NOMBRE
TEL/CELL
EMAIL
DATE BUSINESS ESTABLISHED / FECHA QUE INICIO EL NEGOCIO
SOLE PROPRIETOR/UNICO PROPIETARIO
SOLE PROPRIETOR/UNICO PROPIETARIO
PARTNERSHIP/SOCIEDAD
PARTNERSHIP/SOCIEDAD
CORPORATION
CORPORATION
S CORP
S CORP
BUSINESS INDUSTRY/CATEGORIA DE NEGOCIO
SECONDARY CONTACT PERSON / PERSONA DE CONTACTO SECUNDARIO
NAME/NOMBRE
ADDRESS/DIRECCION
CITY/CIUDAD
ZIP CODE
EMAIL
TELL/CELL
MEMBERSHIP FEE PER YEAR / CUOTA DE MEMBRESIA POR AÑO (Select One/Seleccione Uno)
NUMBER OF EMPLOYEES/NUMERO DE EMPLEADOS:
GENERAL MEMBERSHIP/MEMBRESIA GENERAL: $250.00
GENERAL MEMBERSHIP/MEMBRESIA GENERAL: $250.00
BUSINESS WITH 21-49 EMPLOYEES/NEGOCIO CON 21/49 EMPLEADOS: $500.00
BUSINESS WITH 21-49 EMPLOYEES/NEGOCIO CON 21/49 EMPLEADOS: $500.00
BUSINESS WITH 50-100+ EMPLOYEES/NEGOCIO CON 50-100+ EMPLEADOS: $1,000.00
BUSINESS WITH 50-100+ EMPLOYEES/NEGOCIO CON 50-100+ EMPLEADOS: $1,000.00
PROFESSIONAL (NO EMPLOYEES)/PROFESIONAL (NO EMPLEADOS): $125.00
PROFESSIONAL (NO EMPLOYEES)/PROFESIONAL (NO EMPLEADOS): $125.00
NON-PROFIT/ORGANIZACIONES SIN FINES DE LUCRO: $150.00 - Must submit IRS Non-Profit status/Debe someter carta de IRS estatus ONG
NON-PROFIT/ORGANIZACIONES SIN FINES DE LUCRO: $150.00 - Must submit IRS Non-Profit status/Debe someter carta de IRS estatus ONG
By signing this application, you are accepting to become a member of the NORTH SHORE LATINO BUSINESS ASSOCIATION Firmando esta aplicación usted esta aceptando ser miembro de la ASOCIACION DE COMERCIANTES NORTH SHORE
SIGNATURE / FIRMA
DATE / FECHA
PREFERRED PAYMENT METHOD / METODO DE PAGO PREFERIDO
CHECK
CHECK
CREDIT/DEBIT CARD
CREDIT/DEBIT CARD
CASH
CASH
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