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New Member Application
(*) Denotes Required Fields
Company Information
Company: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Web Site:
Business Category #1:
Please contact us with questions regarding business categories.
Full-time Employees:
Part-time Employees:
Members-only Access
Members-only allows you to update your information online via a secure login.
Admin E-mail: *
Password: *
Verify Password: *
Primary Contact Person
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Use Company contact information above.
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Billing Contact Person
Send bills to Primary Contact above.
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Use Company contact information above.
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Additional Company Representatives
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Additional Business Information
Business Established:
How did you hear about us:
Description of Business. Please limit to 500 characters (one short paragraph).
Online Directory
Enhanced Listing

Increase your Web site traffic by adding an Enhanced Listing for $25. An Enhanced Listing includes a 2nd business category listing and up to 4 links to your social media sites such as Facebook, LinkedIn, YouTube, Pinterest, Google+, etc. Click here to see an example.
$25.00
Business Category #2:
Social Network #1:
Social Network #2:
Social Network #3:
Social Network #4:
Online Ads
Click here to see an example.
Investment Schedule
Annual Investment:$295.00
Number of EmployeesAmount
1 thru 10$295.00
11 thru 25$365.00
26 thru 50$445.00
51 thru 100$530.00
101 thru 200$635.00
Over 200 Employees$880.00
__________
Total:$295.00
Payment Options
(*) Denotes Required Fields
725 S. Adams Rd. Suite 130      Birmingham, Michigan 48009      P 248.644.1700      F 248.644.0286