Membership Application

Business Name

Owner's Name

Contact Person Name

Title

Business Location Address

City, State ZIP

Mailing Address

City, State, ZIP

Phone Number

Cell Phone Number

Fax Number

Email Address

Web Site URL

Description of Business

Business Anniversary Date/

Date Business Opened
(day/month/year)

Please, include a photo of

your business for inclusion ____New Member _____Renewal ______Date
in our website

$ 105.00 1 Year

$ 150.00 2 Years

$ 250.00 3 Years

$__________.00 $5.00 x _____ employees

Please fill out this form and mail it with your check (made payable to SDBA) to:
SDBA/Attn. Membership-7752 West Vernor Hwy. Detroit, MI 48209
For more information, or to pay by Credit Card, please contact Myrna Segura at:
(313) 842-0986 x 36 or myrnas@southwestdetroit.com