New Member Application Please enable JavaScript in your browser to complete this form.Company NameRepresentative's Full Name *Company Email Address *Personal Email Address (if different)Company Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOur mailing address is differentMailing address if different from company addressAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *FaxWebsiteFacebookTwitter Other Social MediaMembership Type *Select one...Entrepreneur $250 USDSmall Business $310 USDMedium Business $650 USDLarge Business $1,200 USDCorporate $2,500 USDNonprofit (1 Person) $250 USDNonprofit (2-10 employees) $310 USDNonprofit (11-25 employees) $650 USDNonprofit (26-50 employees) $1200 USDNonprofit (51+ employees) $2,500 USDPublic Institution $650 USDElected Official $325 USDGovernment Agency $650 USDCompany Representatives To all membership investment levels, excluding Entrepreneur/Individuals, please list any employees with your company to whom you would like updates and mailings sentAreas of Interest (Please check all that apply)Business Development and TrainingGovernment Relations and AdvocacyInternational TradeMembership DevelopmentSpecial EventsEducationNetworkingAdvertisingWebsite AdvertisingMain Banner on home page (entire year) - $7,500.00Company logo above directory listing (entire year) - $150.00Does your company have a physical location? *Select one...YesNoCompany Description *Please provide a brief description of your company Check all business classifications that applyConstruction & ContractorsConstruction & Engineering ManagementConstruction and Concrete CompaniesCommunity ServicesChamber of CommerceCommercialDance InstructionDentistsElectricEntertainmentEducational & Financial AdvocatesEmergency ResponseEmployment & TrainingEmploymentEnvironmental Services and EcologyEducationFinancial Planning & ServicesFinance & InsuranceFitnessGrant WritingGraphic Design ServicesGovernment AgenciesHealth & WellnessHomeHome loansHospitalsJanitorialLand DevelopmentLand SurveyingLand SurveyingLodging & TravelFlooringGasGas & ElectricHealth CareHVACHospitalityMusicLandscape ServicesMovingMunicipalitiesMerchant ServicesMedical Supply InspectionMedical Supply DistributionMedicalNehemiah Emerging Leaders Program (NELP)NonprofitPet ServicesPolitical AdvocacyProtection ServicesPsychologistsPublic TransportationReal EstateReal Estate Agencies & BrokersRestaurants, Food & BeveragesRetail ServicesStorageSchoolSportsSports & RecreationShopping & Specialty RetailService & RepairSecurity TechnologySafety EquipmentTechnical AssistanceTaxesTrucking ServicesTransportation ServicesTranslation ServicesTravel AgencyTechnologyTelecommunication ServicesTheatresVideo ProductionVideo StreamingDemographics (please select all that apply) African American OwnedHeadquarters in SacramentoWoman OwnedCertificationsIs your business certified with State of California?YesSB/DVBE CertificationsMWBEDVBEWBELGBTESMUDPG&ECALTRANSCITY OF SACRAMENTOSACRAMENTO REGIONAL TRANSITOtherIf other, please explain (SB/DVBE Certifications)Is your business licensed with the City of Sacramento?YesHow did you find out about the CAPBCC? (Please select all that apply) StaffWebsiteAdvertisementMemberOtherHow you found us (other) - please explainAuthorization *I hereby authorize and consent permission for CAPBCC to use information provided on this application to be published in our newsletter, website, and directory. I authorize CAPBCC and their sponsors to mail, email or fax me information. I grant CAPBCC the right to take photographs and display them, whether known by me or not, in their marketing and media coverage of events and/or monthly publications. I understand that membership is nonrefundable. The Board of Directors has the right to accept or reject any application for membership.Total$0.00 Continue to Secure Payment
