NBBE Membership Form

Nashville Black Business Expo Membership Request Form
Year Business Established
Company / Business Name
Contact Name*
Mailing Address
Contact Phone
Contact Fax
Contact Email*
Number of Employees
Membership Level* (Please Select the Membership Level That Corresponds with you business entitiy. Membership Fees are annual.)	$25 Student $50 Individual $100 Non-Profit $200 Small Business $500 Corporate
What would you like to gain from organizational membership.

Business Structure(Select All That Apply)	Sole Proprietor Partnership Corporation Non-Profit Joint Venture Minority Owned
Description of Business Services Provided
Technical and Training Needs
Community and Economic Concerns

Please complete this form and return it to: Nashville Black Business Expo PO Box 281034 Nashville, TN 37228