subject_line
Membership Application
Date of application?
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In business since:
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Business Name:
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Day phone number?
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Business owner's name?
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After hours (emergency) phone number?
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Hours of operation?
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Street Address
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City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Contact person's name?
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Contact person's phone number?
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Fax number?
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Email Address
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Description of business:
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Web address?
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Brochure category list (A brief description of services that you provide (NOTE: description will appear on our brochure and website so if you have different descriptions for different categories, please specify - you can email our president at president@downtownroseville.org so that our brochure and website are accurate)
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Dining
Shopping
Services
Community Resource
Are interested in volunteering on any committees/projects/events? List interest below
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Yes
No
Are interested in being nominated to the Board of Directors when the opportunity is available?
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Yes
No
List interests below
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