Lambda Application

Lambda Application

Please completely fill in (as appropriate) and submit the below membership application form.

Remember to mail your check to us, if you are paying by check. If you are paying by credit card, a LAMBDA representative will call you for your credit card information.

NOTE: All fields marked RED are required.
MEMBERSHIP CATEGORY
(Please select)
Regular Business / Professional - $125.00
Additional Member Owned Business - $100.00
Associate Member - $85.00
Community Organization (Directory listing only) - $25.00
PAYMENT METHOD
(Please select)
Check - I'll mail a check.
Pay Pal - I'll fill in the payment details on the next page.
Credit card - I'll fill in the payment details on the next page.
MEMBERSHIP INFORMATION
Applicant's Name:
Title:
Business Name:
License #:
BUSINESS STREET ADDRESS
Address:
 
City:
State:
Zip Code:
MAILING ADDRESS
(if different)
Address:
 
City:
State:
Zip Code:
PHONE NUMBERS
Business Phone:
( ) -   x
Cell Phone:
( ) -   x
Other Phone:
( ) -   x
Fax:
( ) -   x
EMAIL & WEBSITES
Your Email Address:

Membership includes you in our e-mail list, so that you will receive e-mails from Lambda
of upcoming events, member announcements and other membership information.

Additonal Email:
Your Website Address:
http://
Additional Website:
http://
EXCLUSIONS

PLEASE CHECK ANY ITEMS YOU WANT TO REMAIN PRIVATE
(IE, EXCLUDED FROM YOUR ONLINE LISTING)
Physical Address    Mailing Address    Business Phone   
Cell Phone    Other Phone    Facsimile    E-mail    Website
CATEGORIES
Business Category:

ADDITIONAL DIRECTORY LISTING SERVICES

You can enhance your free directory listing by being listed in up to two additional
(appropriate) categories, and/or adding bold text describing your business,
products and/or services (up to 150 characters).

Additional Text - $10.00 per year (included in all your categories)
Additional Category / Categories - $10.00 (each per year)
BECOME INVOLVED
I am interested in hosting a mixer.
I am interested in volunteering for LAMBDA.
COMMENTS

PLEASE MAKE SURE ALL THE INFORMATION IN THIS
FORM IS CORRECT BEFORE YOU SUBMIT THE FORM

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