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

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(1)

B

USINESS

M

EMBERSHIP

A

PPLICATION

M

ICHIGAN

B

USINESS

& P

ROFESSIONAL

A

SSOCIATION

M

ICHIGAN

F

OOD

& B

EVERAGE

A

SSOCIATION

27700 Hoover Road, Warren, MI 48093 • Phone: 888-277-6464 • Fax: 586-393-8810 • Website: www.michbusiness.org

Company Name

Representative’s First Name

Web Site Address

Address 1

City

SIC Code/Industry

Last Name

E-mail (required)

Phone Fax (required)

State Zip # of Locations

Year Company Started # Employees - Full-time/Part-time

How would you like us to communicate with you? (check all that apply) Title

Fax Mail E-mail Phone Is this a family owned business?

Yes No

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? _____________________________________________________ ____________________________________________________________________________________________________________________________________

P

LEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP

.

M

EMBERS

H

ELPING

M

EMBERS™

Annual

Membership Dues:

Type of Pymt: ❏Check/Money Order payable to MBPA or MFBAAmExVISAMasterCard Card# _________________________________________

Name on Card ______________________________________ Exp. Date ________ Sec Code _______ Signature _____________________________________________ Type of Membership

1-Year 2-Year 3-Year 1-25 Employees ❏$140$190$235 26-100 Employees ❏$240$340$430 Corporate - 100+ 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.

Please check one: Date

MBPA

MFBA

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 DiscountsFree Legal/Employment Hotline

(2)

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________

Business Development (Sales, Marketing, Networking):

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________ ❏I’m Interested in the following events, programs or services, please send more information on:

Business Knowledge

Benefits of hiring a veteranBest Business PracticesBusiness CoachingDTE Energy ConsultingEconomic Business PulseExclusive White PapersLegislative Priorities

Restaurant Business ConsultingSmall Business Healthcare ❏Statistics

❏Workshops - Symposiums

Facilitated Networking

101 Best and Brightest Companies to Work For101 Best and Brightest Sustainable CompaniesFacilitated Networking Packets and BlastsFacilitator posting of Member NeedsForum Discussions

Golf Outing

Members Helping Members DirectoryMetro 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 ComplianceCollege Tuition Discounts

Comcast Business ClassCreative Solutions

Customized Credit Card Solutions

Employee Assistance ProgramsEquipment Leasing

Exclusive WDIV – Click on Detroit Ad DiscountsGasoline Rebates – Superfleet

Family Fun Discounts

FREE Discount Drug and Prescription CardsHome and Commercial Mortgages

Human Resource and Business Law HotlineHuman Resources Consulting and DiscountsLegalShield

Life Insurance Needs

Merchant Credit Card ProcessingReal Estate Listing Discounts ❏Rental Car Discounts

❏Staples Office Supply Discounts ❏Travel Discounts

❏Weight Watchers Discounts ❏Wellco Programs

Legislative Influence

Bottle Recycling and SustainabilityEstate Taxes

Healthcare Reform

Joining our Legislative Task ForceLegislative Receptions

Michigan TaxesTort Reform

Health Care Reform Connect™

Healthreformanswers@michbusiness.org email hotlinkHuman Resouces and General Business Legal HotlinesCompliance Tools and Business Resource GuidesWebinars and Workshops Related to Reform

(3)

B

USINESS

M

EMBERSHIP

A

PPLICATION

M

ICHIGAN

B

USINESS

& P

ROFESSIONAL

A

SSOCIATION

M

ICHIGAN

F

OOD

& B

EVERAGE

A

SSOCIATION

27700 Hoover Road, Warren, MI 48093 • Phone: 888-277-6464 • Fax: 586-393-8810 • Website: www.michbusiness.org

Company Name

Representative’s First Name

Web Site Address

Address 1

City

SIC Code/Industry

Last Name

E-mail (required)

Phone Fax (required)

State Zip # of Locations

Year Company Started # Employees - Full-time/Part-time

How would you like us to communicate with you? (check all that apply) Title

Fax Mail E-mail Phone Is this a family owned business?

Yes No

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? _____________________________________________________ ____________________________________________________________________________________________________________________________________

Please check one: Date

MBPA

MFBA

M

EMBER

R

EFERRAL

P

ROGRAM

I

NFORMATION

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: ________________________________________

P

LEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP

.

M

EMBERS

H

ELPING

M

EMBERS™

Annual

Membership Dues:

Type of Pymt: ❏Check/Money Order payable to MBPA or MFBAAmExVISAMasterCard Card# _________________________________________ Name on Card ______________________________________ Exp. Date ________ Sec Code _______ Signature _____________________________________________

Type of Membership

1-Year 2-Year 3-Year 1-25 Employees ❏$140$190$235 26-100 Employees ❏$240 ❏$340 ❏$430 Corporate - 100+ 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.

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 DiscountsFree Legal/Employment Hotline

(4)

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________

Business Development (Sales, Marketing, Networking):

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________ ❏I’m Interested in the following events, programs or services, please send more information on:

Business Knowledge

Benefits of hiring a veteranBest Business PracticesBusiness CoachingDTE Energy ConsultingEconomic Business PulseExclusive White PapersLegislative Priorities

Restaurant Business ConsultingSmall Business Healthcare ❏Statistics

❏Workshops - Symposiums

Facilitated Networking

101 Best and Brightest Companies to Work For101 Best and Brightest Sustainable CompaniesFacilitated Networking Packets and BlastsFacilitator posting of Member NeedsForum Discussions

Golf Outing

Members Helping Members DirectoryMetro 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 ComplianceCollege Tuition Discounts

Comcast Business ClassCreative Solutions

Customized Credit Card Solutions

Employee Assistance ProgramsEquipment Leasing

Exclusive WDIV – Click on Detroit Ad DiscountsGasoline Rebates – Superfleet

Family Fun Discounts

FREE Discount Drug and Prescription CardsHome and Commercial Mortgages

Human Resource and Business Law HotlineHuman Resources Consulting and DiscountsLegalShield

Life Insurance Needs

Merchant Credit Card ProcessingReal Estate Listing Discounts ❏Rental Car Discounts

❏Staples Office Supply Discounts ❏Travel Discounts

❏Weight Watchers Discounts ❏Wellco Programs

Legislative Influence

Bottle Recycling and SustainabilityEstate Taxes

Healthcare Reform

Joining our Legislative Task ForceLegislative Receptions

Michigan TaxesTort Reform

Health Care Reform Connect™

Healthreformanswers@michbusiness.org email hotlinkHuman Resouces and General Business Legal HotlinesCompliance Tools and Business Resource GuidesWebinars and Workshops Related to Reform

(5)

B

USINESS

M

EMBERSHIP

A

PPLICATION

M

ICHIGAN

B

USINESS

& P

ROFESSIONAL

A

SSOCIATION

M

ICHIGAN

F

OOD

& B

EVERAGE

A

SSOCIATION

M

EMBERS

H

ELPING

M

EMBERS™

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 DiscountsFree Legal/Employment Hotline

Company Name

Representative’s First Name

Web Site Address

Address 1

City

SIC Code/Industry

Last Name

E-mail (required)

Phone Fax (required)

State Zip # of Locations

Year Company Started # Employees - Full-time/Part-time

How would you like us to communicate with you? (check all that apply) Title

Fax Mail E-mail Phone Is this a family owned business?

Yes No

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? _____________________________________________________ ____________________________________________________________________________________________________________________________________

M

ICHIGAN

B

USINESS

& P

ROFESSIONAL

A

SSOCIATION

• M

ICHIGAN

F

OOD

& B

EVERAGE

A

SSOCIATION

27700 Hoover Road, Warren, MI 48093 • Phone: 888-277-6464 • Fax: 586-393-8810 • Website: www.michbusiness.org

Please check one: Date

MBPA

MFBA

P

LEASE INDICATE YOUR DESIRED TYPE OF MEMBERSHIP

.

Annual

Membership Dues:

Type of Membership

1-Year 2-Year 3-Year 1-25 Employees ❏$140 ❏$190 ❏$235 26-100 Employees ❏$240$340$430 Corporate - 100+ 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 MFBAAmExVISAMC Card# ___________________________________________ Name on Card ______________________________________ Exp. Date ________ Sec Code _______ Signature _____________________________________________ TradeFirst Acct. Name ________________________________________________ TradeFirst Acct.# __________________________________________________________

(6)

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________

Business Development (Sales, Marketing, Networking):

Name___________________________________________________________________________________________________________________ Phone _________________________________________ Email __________________________________________________________________ ❏I’m Interested in the following events, programs or services, please send more information on:

Business Knowledge

Benefits of hiring a veteranBest Business PracticesBusiness CoachingDTE Energy ConsultingEconomic Business PulseExclusive White PapersLegislative Priorities

Restaurant Business ConsultingSmall Business Healthcare ❏Statistics

❏Workshops - Symposiums

Facilitated Networking

101 Best and Brightest Companies to Work For101 Best and Brightest Sustainable CompaniesFacilitated Networking Packets and BlastsFacilitator posting of Member NeedsForum Discussions

Golf Outing

Members Helping Members DirectoryMetro 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 ComplianceCollege Tuition Discounts

Comcast Business ClassCreative Solutions

Customized Credit Card Solutions

Employee Assistance ProgramsEquipment Leasing

Exclusive WDIV – Click on Detroit Ad DiscountsGasoline Rebates – Superfleet

Family Fun Discounts

FREE Discount Drug and Prescription CardsHome and Commercial Mortgages

Human Resource and Business Law HotlineHuman Resources Consulting and DiscountsLegalShield

Life Insurance Needs

Merchant Credit Card ProcessingReal Estate Listing Discounts ❏Rental Car Discounts

❏Staples Office Supply Discounts ❏Travel Discounts

❏Weight Watchers Discounts ❏Wellco Programs

Legislative Influence

Bottle Recycling and SustainabilityEstate Taxes

Healthcare Reform

Joining our Legislative Task ForceLegislative Receptions

Michigan TaxesTort Reform

Health Care Reform Connect™

Healthreformanswers@michbusiness.org email hotlinkHuman Resouces and General Business Legal HotlinesCompliance Tools and Business Resource GuidesWebinars and Workshops Related to Reform

References

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