Become a Small Business Club or a WIN member!

If you are interested in becoming a member of Small Business Club Niagara (SBCN) or Women In Niagara (WIN), please fill out the following form and our staff will reply to your submission.

• If you are already a member of SBCN or WIN and would like to become a member of both DO NOT FILL OUT THIS APPLICATION, please login to your members area and choose Manage Membership.

MEMBERSHIP INFORMATION (* Required Fields)
Membership For *	SBCN WIN SBCN and WIN
CONTACT INFORMATION (* Required Fields)
Name *
Login Name *	(3 to 8 letters, no numbers, blank spaces or punctuation marks)
Email Address
Main Phone *
Sec Phone
BUSINESS INFORMATION (* Required Fields)
Business Name *
Contact Name *
Address *
City *
Province *
Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Ontario
Postal Code *  (L2B 4Y9)
Phone Number *
Ext.
Alternate Phone Number
Fax
Email Address
Web Site Address  (www.sbcn.ca)	http://
Type of Business	--choose-- Sole Proprietorship Partnership Corporation --choose--
Business Category	--choose-- Accommodations Accounting/Bookkeeping Advertising & Promotion Air Conditioning & Heating Antiques Artists Appliance Services Automotive Barter Books Business Services Career Development Catering Certified Coach Child Care Clothing Computer Services Conference and Event Planning Construction/Repairs/Maintenance Consultants Counselling Desktop Publishing Direct Sales E Commerce Electrical Engineering Entertainment Environmental Equipment Repairs/Maintenance Financial Services Fishing Charters Fitness Floor Treatments Floral Food Services Gifts/Toys/Crafts Graphic Design Hairstylist Health Services Horticultural Import/Export Insurance Interior Décor Internet Services Janitorial/Cleaning Kitchens and Bathrooms Labelling Landscaping Legal Services Manufacturing Marketing Massage Therapist Mortgages Natural Food Not-for-Profit Office Equipment Packaging Painting Personal Services Pet Service Photography Plumbing Public Relations Publishing Purchasing Real Estate Rehab Services Rentals Residential Services Retail Security Systems Senior Services Signage Software Development Sporting Goods Telecommunications Tourism/Hospitality Training/Instruction Translators Transportation/Moving/Storage Travel Vending Service Warehousing Water Retail Web Site Design Weddings and Occasions Winery --choose--
Date Established  (yyyy/mm/dd)
No. of Full-Time  Employees
No. of Part-Time  Employees
How did you hear about  SBCN?:	Training Program Newspaper Word of Mouth Other
If other, please state:
Business Description:(Unlimited characters)
Method of Payment:	Bill by mail VISA MasterCard (If method of payment is by Credit Card please call 905-685-6100 with card # to enable membership)
By submitting this form, I acknowledge the Small Business Club Niagara Inc. may make the above information available to other persons as it considers appropriate, either in exchange for information or otherwise and I hereby consent to such use of the information.
SBCN offers an "ad-mail" service to our members for $50.00 per submission. All submissions are approved by the board prior to being released.
I agree to receive SBCN ad-mail?
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