Membership Application

Please print out this form and send, along with your check (and business or calling cards cards if you'd like for your badge and website listing), to
       Northwest Business Club
        P.O. Box 31365
        Bellingham, WA  98228-3365
_______________________________________________________

I would like to apply for membership in the Northwest Business Club.
I understand that this is an individual membership.

            ___  Annual Dues $100
            ___  Semi-Annual Dues $50 (subject to review & approval)
          
Name _________________________________________________________________

Business ______________________________________________________________

Address _______________________________________________________________

City, State, Zip __________________________________________________________

Phone __________________________________     Cell _________________________

E-Mail ___________________________________________________________

Website __________________________________________________________