"Soaring To New Heights"

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P.O. Box 60574
Corpus Christi, TX 78466
(361) 698-2116 (off)
(361) 698-2112 (fax)

MEMBERSHIP APPLICATION

BUSINESS/CORPORATION

Business Name: 

Contact Name/Title: 

Mailing Address: 

Physical Address: 

Business Type: 

   # of Employees:

Email:

Telephone Number: 

 Fax Number:  
 

Signature & Date:  _____________________________________________

 

ASSOCIATE (Non-Business Owner)

Name:

Mailing Address: 

Email:

Home Number: 

  

    Cell Number:

  
 

Signature & Date:  _____________________________________________

 

MEMBERSHIP INVESTMENT*

$100.00 (up to 5 employees)

  

$350.00 (up to 30 employees)

  

$125.00 (up to 10 employees)      

  

$450.00 (up to 50 employees)

 

$250.00 (up to 20 employees)        

  

$750.00 (over 50 employees)

  

  $85.00 - Religious/Civic/Non-Profit Groups

  $75.00 - Associate (Non-Business Owner)

  $50.00 - Collegiate/Young Professionals (18-25 years of age)

* Membership Expires one (1) year from date of enrollment

                    NEW MEMBER

 RENEWAL
      PAID BY:         Cash                   Check # ___________           Send Invoice (Net 30)

 

F.M.I.:  VP of Membership, Mrs. Violet Russell-Edwards (361) 438-5830

Pres/CEO, Mrs. Sylvia Tryon Oliver (361) 877-3634     *     Chairman, Dr. Geraldine Johnson (361) 779-5656

 

  

Effective:  January, 2007

     

 

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