Form

Name

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Name (For Partnership Businesses)

Street Address

CONTACT NUMBER (HOME)

WORK: Claro/ Dig./Lime

CELL: Claro/Dig./Lime

BIRTHDAY / ANNIVERSARY

GenderMaleFemale

EMAIL ADDRESS

Emergency Contact

BUSINESS INFORMATION

BUSINESS NAME

TITLE

POSITION

Street Address

BUSINESS CONTACT

Email Address

Website

PRODUCTS / SERVICES

LEVEL OF MEMBERSHIP

Micro Business (1-5 employees) - $3,000. 00Small Business (6-20 employees) - $10,000.00Medium Business Enterprise (21-100 Employees) - $15,000.00Associated Company - $15,000.00

Note: Membership fees are due January of each year, and are NONE REFUNDABLE.

EXPECTATIONS OF THE SBAJ

I hereby certify that the information given herein is true and complete to the best of my knowledge.

Signature of Applicant _

Date

Release of information: (Place "X" in the appropriate box): I DO want the above information released if requested by other members and/or to be provided to the membershipbenefit companies affiliated with this organization.(Regardless of option checked, no information is released outside of this organization).. Please provide copies of supporting documentation the business being registered for membership. Thank you for applying for membership in the Small Business Association of Jamaica.Release of information: (Place "X" in the appropriate box): I DO NOT want the above information released if requested by other members and/or to be provided to the membershipbenefit companies affiliated with this organization.(Regardless of option checked, no information is released outside of this organization).. Please provide copies of supporting documentation the business being registered for membership. Thank you for applying for membership in the Small Business Association of Jamaica.

FOR OFFICIAL USE ONLY

All information provided is confidential and intended for the sole use of the Small Business Association of Jamaica
(SBAJ)

Comments (Assessment Officer)

Signature of Officer:

Director’s Approval:

Membership Number:

Membership Category:

Small Business Association of Jamaica

Small Business Association of Jamaica

MEMBERSHIP APPLICATION FORM

I hereby certify that the information given herein is true and complete to the best of my knowledge.

Small Business
Association of Jamaica

Small Business
Association of Jamaica