MEMBERSHIP APPLICATION

July 16th Party PB steakhouse

(Please make checks payable to
Palm Beach Business Group, Inc.) 
               Membership in the Palm Beach Business Group, Inc.  
includes attendance at monthly breakfast meeting (with speakers) and 
 special networking and educational events,   normally without additional cost.  Members can link their website to the PBBG site, which will be promoted is a 501(C)3 organization.

We encourage our members to network and promote business with and for each other. Additionally, we foster education and civic pride through our speakers and special events.

 Individual Membership is $100 per year, pro-rata for January to

December Corporate membership is $100 per year for the first corporate representative, and $75 for each additional company representative. Corporate Sponsorship is $500/year, pro-rata January to December.  Sponsorship includes three corporate representatives, plus promotional literature made available at meetings and events.

I/We hereby apply to be a member of the Palm Beach Business Group, as;
_____ Individual Member for $100 annual fee.
_____ Corporate Member for $100 annual fee, plus ____ representatives at $50 each.
_____ Corporate Sponsor for $100 amnnual fee.
Company Name:___________________
Individual Name:___________________
Address: __________________________
City:__________________ State_______ Zip: _________
Phone:_______________Fax :_____________website :_________
Type of Business: _________________________
Additional Representatives names:________________
Agreed this _________ day of ______________ 2006

___________________
Signature

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