Membership Application

2019-2020

Name ___________________________________________________________

Address _________________________________________________________

City ______________________ State ____________ Zip Code ________

Home Phone _________________ Cell Phone _______________________

Office Phone ________________ Other Phone _____________________

Email Address ___________________________________________________

Name of Employer ________________________________________________

Position__________________________________________________________

Other Membership Affiliations:

Are there any particular interests you have in the Business & Professional Women organization?

Additional Comments:

__________________________________________________________________________________________________________________________________________________________________

Your Signature

Date __________________________________________________

Sponsored by (BPW Member) ____________________________

Please mail application and check for $100.00 made payable to BPW North Sarasota, to P.O. Box 1121, Sarasota, FL 34230

Thank you!