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Membership Application Form

Small Business Association of Jamaica · 2 Trafalgar Road, Kingston 5

Tel: 876-978-0168 / 876-978-9191 · Cell: 876-579-9431 · www.sbaj.org.jm

General Information

Title

First Name

Last Name

Title

First Name (Partnership Businesses)

Last Name (Partnership Businesses)

Upload Your Photo

Home Address

Contact Number (Home)

Work Number

Work Carrier

Cell Number

Cell Carrier

Birthday / Anniversary

Gender

Female Male

Email Address

Emergency Contact — Name

Emergency Contact — Tel

Business Information

Business Name

Title / Position

Business Address

Tel

Fax

Cell

Business Email

Website

Business Details

Is your business registered?

Yes No

Registration No.

TRN No.

Existing / New Business

New Existing

Business Category

Service Products

Select Category

Number of Years in Operation

Target Market

Number of Employees

Full-Time

Part-Time

Total

Products / Services

Level of Membership

Micro Business (1–5 employees) — $3,500.00 Small Business (6–20 employees) — $10,000.00 Medium Business Enterprise (21–100 employees) — $20,000.00 Associated Company — $25,000.00

Note: Membership fees are due January of each year, and are NON-REFUNDABLE.

Business Assistance Required

Expectations of the SBAJ

Other Information

Select the COMMITTEE of the SBAJ on which you would be willing to serve

List in the SBAJ Business Directory?

Yes No

Are you employed to another company?

Yes No

What is your area of expertise / experience?

Declaration

I hereby certify that the information given herein is true and complete to the best of my knowledge.

Signature of Applicant (type your full name)

Date

Release of Information

I DO want the above information released if requested by other members and/or provided to the membership-benefit companies affiliated with this organization. I DO NOT want the above information released if requested by other members and/or provided to the membership-benefit companies affiliated with this organization.

Regardless of the option checked, no information is released outside of this organization. Please provide copies of supporting documentation for the business being registered for membership.

Small Business Association of Jamaica

SBAJ Member Application

Membership Application Form

Small Business
Association of Jamaica