Membership Application------- Printable version

Business name: _______________________________________________

Address:   ___________________________________________________

City/State/Zip: _______________________________________________

Phone: _________________________ Fax: _________________________

Website: _____________________________________________________

Type of business: ______________________________________________ 

Year Founded: ______________# of Full-time (FTE) Employees: ________

Total family members active in business: ____    # of generations: ______

List all family and key non-family members involved in the business:
Name & Position in Company

1)___________________________________________________________

E-mail:__________________________________

2)___________________________________________________________

E-mail:__________________________________

3)___________________________________________________________

E-mail:__________________________________

4)___________________________________________________________

E-mail:__________________________________
(Use the back of this page or a separate sheet to list additional members.)

2008 Membership Rates*
20 or less employees                                            $300
21-75 employees                                                 $500
76 or more employees                                          $700

All-inclusive membership                                       $2000

Professional Membership**                                  $500
*Note: Membership rates are based upon total number of company employees (full-time equivalent).  **Non-family owned business professionals, individual membership.

Please make checks payable to PFBA and mail to:

Prairie Family Business Association
USD School of Business
2205 North Career Ave
Sioux Falls, SD 57107
 

For credit card payments, complete "Printable form" then, mail to the above address or fax to (866) 624-8161