Membership Application - Bristol County Business Collaborative

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Step 1 of 3

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Name*

First Last

Is this is a renewal?*

Yes

No - I am a possible new member

Company Name*

Position in company*

Business Category or Industry*

Phone*

Cell Phone

Website

Email*

Business Address*

Street Address Address Line 2 City State ZIP Code

Experience in Professional Business Category or Industry (be specific):*

Length of time in Business Category or Industry:*

How long have you been at your current company?*

Education background in Professional Business Category or Industry or Degrees,current Licenses or Credentials required to perform in Professional Classification (list school/state and/or business/state):*

Is the Business Category or Industry under which you are applying for membership your primary occupation?*

Yes

Has the professional license of the applicant ever been suspended or revoked?*

Yes

Why was it suspended or revoked and what was the result?*

Are you currently involved with another networking group?*

Yes

What is the name of the group?*

Have you ever belonged to another networking group?*

Yes

Name(s) of the group(s)?*

Are you willing and able to send a substitute if you are unable to attend a meeting?*

Yes

Are you willing and able to bring referrals and/or visitors to this chapter?*

Yes

References

Name*

Phone*

Email*

Business Name/Type*

Name*

Phone*

Email*

Business Name/Type*

CAPTCHA

Signature

Consent*

I acknowledge and consent.

BCBC APPLICATION – TERMS AND CONDITIONS

By submitting your application for membership to Bristol County Business Collaborative (“BCBC”), you hereby agree, acknowledge, and consent, as the case may be, to the following terms and conditions.

Accuracy of Information—All of the information you provided on your application is true and correct and understand that and consent to BCBC verifying any and all information you provided in addition to contacting you for clarification or additional information which you agree to timely supply. You affirmatively state that you are duly licensed, certified, or otherwise have the required knowledge, skill, experience, licenses, permits, approvals, and the like to conduct the business and carryout the services you are offering. In the event at time while a member of BCBC any required license, permit, approval, or the like expired, is revoked, suspended, or is no longer valid you will immediately notify the BCBC Board of Directors.

Identity—You hereby certify that you are the person who is named on the application being submitted to BCBC and understand that any falsification of this statement and/or of any other information provided on the application may be considered fraud and is grounds for denial of your application and/or immediate termination of membership in BCBC.

Term—You understand that your application is for a term of only one (1) year of membership. Accepted applications between the first (1st) and the fifteenth (15th) of the month shall begin their term on the first (1st) of that month. Accepted applications after the fifteenth (15th) of the month shall begin their term on the first (1st) of the following month. You must submit an application each year to renew your membership, including providing any updated information. Submitting an application for membership to BCBC does not guarantee your membership.

If your application is accepted, membership to BCBC is limited to you, not to your business or anyone else in your company or industry. BCBC considers all memberships to be “individual.”

Membership Fee—Membership fees (or any additional room dues, location fees, etc.) which you pay in connection with your membership with BCBC are nonrefundable. If your application is denied for membership with BCBC, the membership fee you are paying today will be refunded.

Bylaws—You acknowledge that you have read, understand, and agree to the Bylaws of BCBC and will adhere to them as they may be amended from time to time. You agree to abide by and comply with all BCBC policies, guidelines, and ethics, whether now in place or in the future.

Photos; Social Media—You understand and hereby expressly authorize and grant permission for the use of photos and videos (or other electronic media images) which you may be in can and may be used by BCBC for public viewing, promotional, and social media purposes, including, without limitation, posted on the BCBC website, Facebook, and/or any member’s Facebook, Instagram, or other social media and public platform.

Governing Law—These terms and conditions and the Bylaws of BCBC in addition to all written policies and guidelines are governed by the laws of the Commonwealth of Massachusetts and you hereby knowingly and voluntarily agree to the personal jurisdiction and venue of the courts sitting in Bristol County, Massachusetts.

General—These terms and conditions may be amended or updated from time to time without prior notice.

Name

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