Belton Area Partnership
Membership Application Form

Please print this form after completing and mail to the address at the bottom of the page.

Please provide the following contact information:

Name

Title

Organization

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Work Phone

Home Phone

FAX

E-mail

Enter date -- mm/dd/yy

Total dues based on schedule below?

Annual Dues Schedule

Individual - $50 / Couples - $100

Nonprofit Organization - $200

Businesses

5 or fewer employees - $200

6 to 25 employees - $400

26 to 50 employees - $700

51 or more employees - $700 plus $2.00/employee over 50

Non-resident Associate - $100

Notes: Dues are payable January 1 each year. Dues for new
members joining during the year will be prorated. Dues for
businesses are based on the number of full-time employees.

Make checks payable to Belton Area Partnership and mail to:

Belton Area Partnership

P.O. Box 83

Belton, SC 29627

Belton Area Partnership Membership Application Form

Please print this form after completing and mail to the address at the bottom of the page.

Belton Area Partnership
Membership Application Form