Your Name

Business Category (e.g. real estate, financial planning)

Company Name

Company Address

Company Phone

Your Email

Home Address

Please describe the nature of your business/service.

Business is a:
Sole ProprietorshipCorporationPartnershipNon-Profit Corporation

Your position is:
OwnerPartnerIndependent DistributorManagerSales

Length of time in business?

Do you presently have membership in another networking organization(s)? YesNo

If YES, please list organization(s).

Dues are $180 per year if paid at one time, and $100 if paid semi-annually. There will always only be one business from a category in the group at one time.

I am signing up for BWI Business Professionals for: 1 year6 months

I agree I have read and agree to abide by the Bylaws.

Please enter your full name.