BUSINESS MEMBERSHIP APPLICATION MICHIGAN BUSINESS & PROFESSIONAL ASSOCIATION MICHIGAN FOOD & BEVERAGE ASSOCIATION

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1 BUSINESS MEMBERSHIP APPLICATION MICHIGAN BUSINESS & PROFESSIONAL ASSOCIATION MICHIGAN FOOD & BEVERAGE ASSOCIATION Company Name Representative s First Name Last Name Date Please check one: MBPA MFBA Title (required) Web Site Address Phone Fax (required) Address 1 State Zip # of Locations City # Employees - Full-time/Part-time Year Company Started SIC Code/Industry Is this a family owned business? Yes No How would you like us to communicate with you? (check all that apply) Fax Mail Phone Tell us about your business and what services you provide. What type of clients/customers are you looking for? What part of running your business is your greatest challenge or causes you the most pain? MEMBERS HELPING MEMBERS Yes, we would like to receive this helpful resource listing of a few other members in our area twice a year at no charge. Yes, we would like to join the MHM discount program at no charge. * Products/services you are willing to discount to other members: * Explain the discount you are willing to offer: Yes, we have a special need, such as an asset for sale, job opening, product need, etc. Please explain what you would like to publicize to other members if space is available: Yes, I d like to sign-up for financial savings with: Free Drug/Vision Discounts Free Legal/Employment Hotline PLEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP. Annual Membership Dues: Type of Membership 1-Year 2-Year 3-Year 1-25 Employees $140 $190 $ Employees $240 $340 $430 Corporate Employees $340 $490 $825 Three dollars of membership dues will apply to an annual subscription to Corp! the magazine dedicated to Michigan business. Check here to be removed from circulation, remove $3 from above dues level. Type of Pymt: Check/Money Order payable to MBPA or MFBA AmEx VISA MasterCard Card# Name on Card Exp. Date Sec Code Signature Hoover Road, Warren, MI Phone: Fax: Website:

2 For more information on Association Programs and Services to Make Your Business Better, please complete the information below and kindly fax it to us at (586) or simply call us at (888) Who in your company is responsible for, if different than primary contact: Health Insurance: Human Resource Needs: Additional Information Request Form Business Development (Sales, Marketing, Networking): I m Interested in the following events, programs or services, please send more information on: Business Knowledge Benefits of hiring a veteran Best Business Practices Business Coaching DTE Energy Consulting Economic Business Pulse Exclusive White Papers Legislative Priorities Restaurant Business Consulting Small Business Healthcare Statistics Workshops - Symposiums Facilitated Networking 101 Best and Brightest Companies to Work For 101 Best and Brightest Sustainable Companies Facilitated Networking Packets and Blasts Facilitator posting of Member Needs Forum Discussions Golf Outing Members Helping Members Directory Metro Detroit Youth Day Monthly Networking Events Social Media: Facebook, LinkedIn, Twitter Women and Leadership in the Workplace Conference Financial Savings Cellular Discounts Cobra Administration Health Care Compliance College Tuition Discounts Comcast Business Class Creative Solutions Customized Credit Card Solutions Employee Assistance Programs Equipment Leasing Exclusive WDIV Click on Detroit Ad Discounts Gasoline Rebates Superfleet Family Fun Discounts FREE Discount Drug and Prescription Cards Home and Commercial Mortgages Human Resource and Business Law Hotline Human Resources Consulting and Discounts LegalShield Life Insurance Needs Merchant Credit Card Processing Real Estate Listing Discounts Rental Car Discounts Staples Office Supply Discounts Travel Discounts Weight Watchers Discounts Wellco Programs Legislative Influence Bottle Recycling and Sustainability Estate Taxes Healthcare Reform Joining our Legislative Task Force Legislative Receptions Michigan Taxes Tort Reform Health Care Reform Connect hotlink Human Resouces and General Business Legal Hotlines Compliance Tools and Business Resource Guides Webinars and Workshops Related to Reform Let us Make Your Business Better, contact us at: phone fax

3 Company Name Representative s First Name BUSINESS MEMBERSHIP APPLICATION MICHIGAN BUSINESS & PROFESSIONAL ASSOCIATION MICHIGAN FOOD & BEVERAGE ASSOCIATION Date Last Name Please check one: MBPA MFBA Title (required) Web Site Address Phone Fax (required) Address 1 State Zip # of Locations City # Employees - Full-time/Part-time Year Company Started SIC Code/Industry Is this a family owned business? Yes No How would you like us to communicate with you? (check all that apply) Fax Mail Phone Tell us about your business and what services you provide. What type of clients/customers are you looking for? What part of running your business is your greatest challenge or causes you the most pain? MEMBERS HELPING MEMBERS Yes, we would like to receive this helpful resource listing of a few other members in our area twice a year at no charge. Yes, we would like to join the MHM discount program at no charge. * Products/services you are willing to discount to other members: * Explain the discount you are willing to offer: Yes, we have a special need, such as an asset for sale, job opening, product need, etc. Please explain what you would like to publicize to other members if space is available: Yes, I d like to sign-up for financial savings with: Free Drug/Vision Discounts Free Legal/Employment Hotline PLEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP. Annual Membership Dues: Type of Membership 1-Year 2-Year 3-Year 1-25 Employees $140 $190 $ Employees $240 $340 $430 Corporate Employees $340 $490 $825 Three dollars of membership dues will apply to an annual subscription to Corp! the magazine dedicated to Michigan business. Check here to be removed from circulation, remove $3 from above dues level. Type of Pymt: Check/Money Order payable to MBPA or MFBA AmEx VISA MasterCard Card# Name on Card Exp. Date Sec Code Signature MEMBER REFERRAL PROGRAM INFORMATION Before providing this membership application to other companies who you believe could benefit from MBPA/MFBA services, please fill-in the following information (Please print): Member Company Name: Member Company MBPA or MFBA Membership #: Member Company Contact Name: Phone: Hoover Road, Warren, MI Phone: Fax: Website:

4 For more information on Association Programs and Services to Make Your Business Better, please complete the information below and kindly fax it to us at (586) or simply call us at (888) Who in your company is responsible for, if different than primary contact: Health Insurance: Human Resource Needs: Additional Information Request Form Business Development (Sales, Marketing, Networking): I m Interested in the following events, programs or services, please send more information on: Business Knowledge Benefits of hiring a veteran Best Business Practices Business Coaching DTE Energy Consulting Economic Business Pulse Exclusive White Papers Legislative Priorities Restaurant Business Consulting Small Business Healthcare Statistics Workshops - Symposiums Facilitated Networking 101 Best and Brightest Companies to Work For 101 Best and Brightest Sustainable Companies Facilitated Networking Packets and Blasts Facilitator posting of Member Needs Forum Discussions Golf Outing Members Helping Members Directory Metro Detroit Youth Day Monthly Networking Events Social Media: Facebook, LinkedIn, Twitter Women and Leadership in the Workplace Conference Financial Savings Cellular Discounts Cobra Administration Health Care Compliance College Tuition Discounts Comcast Business Class Creative Solutions Customized Credit Card Solutions Employee Assistance Programs Equipment Leasing Exclusive WDIV Click on Detroit Ad Discounts Gasoline Rebates Superfleet Family Fun Discounts FREE Discount Drug and Prescription Cards Home and Commercial Mortgages Human Resource and Business Law Hotline Human Resources Consulting and Discounts LegalShield Life Insurance Needs Merchant Credit Card Processing Real Estate Listing Discounts Rental Car Discounts Staples Office Supply Discounts Travel Discounts Weight Watchers Discounts Wellco Programs Legislative Influence Bottle Recycling and Sustainability Estate Taxes Healthcare Reform Joining our Legislative Task Force Legislative Receptions Michigan Taxes Tort Reform Health Care Reform Connect hotlink Human Resouces and General Business Legal Hotlines Compliance Tools and Business Resource Guides Webinars and Workshops Related to Reform Let us Make Your Business Better, contact us at: phone fax

5 Company Name Representative s First Name BUSINESS MEMBERSHIP APPLICATION MICHIGAN BUSINESS & PROFESSIONAL ASSOCIATION MICHIGAN FOOD & BEVERAGE ASSOCIATION Date Last Name Please check one: MBPA MFBA Title (required) Web Site Address Phone Fax (required) Address 1 State Zip # of Locations City # Employees - Full-time/Part-time Year Company Started SIC Code/Industry Is this a family owned business? Yes No How would you like us to communicate with you? (check all that apply) Fax Mail Phone Tell us about your business and what services you provide. What type of clients/customers are you looking for? What part of running your business is your greatest challenge or causes you the most pain? MEMBERS HELPING MEMBERS Yes, we would like to receive this helpful resource listing of a few other members in our area twice a year at no charge. Yes, we would like to join the MHM discount program at no charge. * Products/services you are willing to discount to other members: * Explain the discount you are willing to offer: Yes, we have a special need, such as an asset for sale, job opening, product need, etc. Please explain what you would like to publicize to other members if space is available: Yes, I d like to sign-up for financial savings with: Free Drug/Vision Discounts Free Legal/Employment Hotline PLEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP. Annual Membership Dues: Type of Membership 1-Year 2-Year 3-Year 1-25 Employees $140 $190 $ Employees $240 $340 $430 Corporate Employees $340 $490 $825 Three dollars of membership dues will apply to an annual subscription to Corp! the magazine dedicated to Michigan business. Check here to be removed from circulation, remove $3 from above dues level. Type of Pymt: TradeFirst Dollars (Can only be used for new members for the first year of membership) Check/Money Order payable to MBPA or MFBA AmEx VISA MC Card# Name on Card Exp. Date Sec Code Signature TradeFirst Acct. Name TradeFirst Acct.# MICHIGAN BUSINESS & PROFESSIONAL ASSOCIATION MICHIGAN FOOD & BEVERAGE ASSOCIATION Hoover Road, Warren, MI Phone: Fax: Website:

6 For more information on Association Programs and Services to Make Your Business Better, please complete the information below and kindly fax it to us at (586) or simply call us at (888) Who in your company is responsible for, if different than primary contact: Health Insurance: Human Resource Needs: Additional Information Request Form Business Development (Sales, Marketing, Networking): I m Interested in the following events, programs or services, please send more information on: Business Knowledge Benefits of hiring a veteran Best Business Practices Business Coaching DTE Energy Consulting Economic Business Pulse Exclusive White Papers Legislative Priorities Restaurant Business Consulting Small Business Healthcare Statistics Workshops - Symposiums Facilitated Networking 101 Best and Brightest Companies to Work For 101 Best and Brightest Sustainable Companies Facilitated Networking Packets and Blasts Facilitator posting of Member Needs Forum Discussions Golf Outing Members Helping Members Directory Metro Detroit Youth Day Monthly Networking Events Social Media: Facebook, LinkedIn, Twitter Women and Leadership in the Workplace Conference Financial Savings Cellular Discounts Cobra Administration Health Care Compliance College Tuition Discounts Comcast Business Class Creative Solutions Customized Credit Card Solutions Employee Assistance Programs Equipment Leasing Exclusive WDIV Click on Detroit Ad Discounts Gasoline Rebates Superfleet Family Fun Discounts FREE Discount Drug and Prescription Cards Home and Commercial Mortgages Human Resource and Business Law Hotline Human Resources Consulting and Discounts LegalShield Life Insurance Needs Merchant Credit Card Processing Real Estate Listing Discounts Rental Car Discounts Staples Office Supply Discounts Travel Discounts Weight Watchers Discounts Wellco Programs Legislative Influence Bottle Recycling and Sustainability Estate Taxes Healthcare Reform Joining our Legislative Task Force Legislative Receptions Michigan Taxes Tort Reform Health Care Reform Connect hotlink Human Resouces and General Business Legal Hotlines Compliance Tools and Business Resource Guides Webinars and Workshops Related to Reform Let us Make Your Business Better, contact us at: phone fax

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