WBA MEMBERSHIP APPLICATION
P. 781-935-0345  F. 781-935-8920
Mailing Address: P.O. Box 3057, Woburn, MA 01888-1857
Physical Address: 10 Tower Office Park, Suite 416, Woburn, MA 01801
Please complete, print, sign and fax this application to the WBA fax #781-935-8920
Membership effective upon receipt of application, applicable dues and approval by the WBA Board of Directors.
Required fields are indicated with bold type and are underlined
Firm Name
Address
City/Town
Mailing Address
Phone           Fax  
Website
E-Mail       
CEO
Primary Contact     Title
Second Contact     Title
Total Employees  Part Time    Full Time  
Woburn Residents  Part Time    Full Time  
GIVE A BRIEF DESCRIPTION OF YOUR BUSINESS TYPE AND PRODUCTS OR SERVICES.
Referred By

Date           Signature ____________________________________________________________________  

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LEVEL
1
2
3
FT EMPLOYEES
1-9
10-19
20-34
DUES
$ 175.00
$ 275.00
$ 415.00
LEVEL
4
5
6
FT EMPLOYEES
34-74
75-100
100-+
DUES
$   550.00
$   660.00
$1,100.00
** $600 PLUS $2.00 PER EMPLOYEE, BUT NO MORE THAN $1,100.00