King William Business Association, Inc.
"The Best Way to Predict the Future is to Create It."
Officers
President:
James Boyer
1st Vice President:
Cecil Schools
2nd Vice President:
Robert Reece
Secretary:
Deborah Byrum
Treasurer:
Robert Powell.
Past President:
Board Members
Susan Bayne
Rodney Horst
Ken Miller
Wesley Walker
Rick Crabtree
Diane Lentz
Garrie Rouse
Web Site
Design by
West Point FBLA
Administrator
Joan Shuster
Email
n
Application for Membership
For any questions or concerns regarding the application process, please feel free to contact Ralph Jones or any other member of our board. Their telephone numbers can be found in the Contact Us section of this website.
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Title: [] Mr. [] Mrs. [] Ms. [] Other___________
________________________________________
First
Name
________________________________________
Last
Name
____________________________________________
Position/Title
____________________________________________
Organization/Company Name
____________________________________________
Mailing
Address
____________________________________________
Street
Address
____________________________________________
City
State
Zip Code
(____)_______________(____)__________________
Home
Phone
Work
Phone
Ext.
(____)____________ _________
Fax
Number
Pager
_______________________
Cell Phone
____________________________________________
E-mail
Address
____________________________________________
Web
Page Address
____________________________________________
Spouse's Name
____________________________________________
Signature
of Applicant
____________________________________________
Referred
By
ANNUAL DUES: $50.00 for Business Voting Members
$25.00 for Non-Voting Associate Members
AMOUNT INCLUDED WITH APPLICATION $______________
Each business may have a maximum of two (2) Voting members. The number of Associate Members is not limited.
Mail this application with your check payable to the King William Business Association, Inc. at:
P.O. Box 403
Manquin, VA 23106-0403