DRM Membership Registration

Membership Application

Date of application? * +

In business since: * +

Business Name: *

Day phone number? *

Business owner's name? *

After hours (emergency) phone number? *

Hours of operation? *

Street Address *

City *

State *

Zip Code *

Contact person's name? *

Contact person's phone number? *

Fax number? *

Email Address *

Description of business: *

Web address? *

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) *

Dining

Shopping

Services

Community Resource

Are interested in volunteering on any committees/projects/events? List interest below *

Yes

No

Are interested in being nominated to the Board of Directors when the opportunity is available? *

Yes

No

List interests below

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