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Membership InformationAbout Our CommunityBusiness ResourcesNewsMember ServicesPublic Policy
Membership InformationAbout Our CommunityBusiness ResourcesNewsMember ServicesPublic Policy

Friday Jul 30, 2010
 51 Monroe Street, Suite 1800, Rockville, MD 20850 P: 301.738.0015 F: 301.738.8792
Member Application

To download the membership application in pdf format please click here.

Part 1 - Membership
 
Company Name
 
Street/Suite
 
   
City   State   Zip
 
 
Member Main Phone/Ext.   Main Fax
 
 
General Email Address   SIC (Standard Industrial Class. Code)
 
Internet/Web Address
 
 
Number of Employees
click here for rates		   Year Business Started
 
Short Business Description (25 words or less)
 
Business is: Home-based (@ residence) Minority Owned International
 
Classified Listing (1st free; $25 each additional)
* Hold CTRL and click to select multiple categories


Part 2 - Representatives
 
Primary: (Receives notices, invoices, newsletter, selects representatives, etc.)
 
   
Dr./Mr./Ms.   Name   Title
 
 
Phone/ext.   Fax
 
E-mail
 
* You will be able to enter additional representatives once your application has been completed.


Part 3 - Reasons for Joining
 
Networking   Community Service   Political Impact
Other  


Part 4 - Referrals
 
   
Dr./Mr./Ms.   Name   Title
 
Company Name
 
Street / Suite
 
   
City   State   Zip
 
 
Phone   Fax


Part 5 - Payment1
 
    Annual Dues (click here for rates)
    Total Cost
 
Payment Type: Check Credit Card
 
Billing Name:
Billing Address:
Billing City:
Billing State:
Billing Zip:
Billing Phone:
Card Number:
Card Type:
Card Exp:  / 



1 Your credit card will not be charged now. It will only be charged if we accept your application. If paying by check, your application can not be approved until your check has cleared.

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Site Last Updated: 16-Apr-09

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