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Membership Application
Company Name
Representative #1 Name
Representative #1 Title
Representative #2 Name
Representative #2 Title
Street Address
City
State
Zip Code
Phone Number
Fax
E-mail Address
Website URL
Year Company Established
Number of Employees
Description of Business
Membership Investment
(Based on # of Employees)
$
290
1-10 Employees
$
345
11-25 Employees
$
425
26-50 Employees
$
510
51-100 Employees
$
615
101-200 Employees
$
860
Over 200 Employees
$
160
Professional in Transition
Enhance my online Directory Listing
$
25/year
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$
100/year
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124 W. Maple Rd. Birmingham, Michigan 48009 P 248.644.1700 F 248.644.0286
