Sustainable Business Network of the Inland Northwest

Membership Application Business name:___________________________________________________ Your name:_________________________________Position:______________ Street address:___________________________________________________ City:________________________State:____Zip:________________________ Mailing address (if different) ____________________________________________ City:________________________State:____Zip:________________________ Phone:_____________________Mobile phone:_________________________ E-Mail:__________________________________________________________ Business Membership Rates:     

(Select one)

Business with annual revenue (or annual budget) under $50,000 12 months - $125 Business with annual revenue (or annual budget) $50,000 to $250,000 12 months - $200 Business with annual revenue (or annual budget) $250,000 to $500,000 12 months - $350 Business with annual revenue (or annual budget) over $500,000 12 months - $500 Other (please specify)____________________________________________ (Please see back of this form for rates for other levels of membership.)

To join as a Business or Sustaining member, you must be able to answer "yes" to all of the following five questions:    



Is my business privately held, not publicly traded? Do the business owners, totaling greater than 50% of the business ownership, live in the Inland Northwest? Is my business based in the Inland Northwest, having no corporate or national headquarters outside the area? Can my business make independent decisions regarding the name and look of the business, as well as all business purchasing practices, and distribution? Does my business pay all marketing, rent, and other business expenses without assistance from a corporate headquarters?

Payment amount enclosed:_____________________________________ Your signature:_______________________________________________ Please make checks payable to “Community Building Foundation.” (The Community Building Foundation is acting as our fiscal sponsor until our tax exempt status is approved.)

Thank you for joining with us to support and encourage local, sustainable business in the Inland Northwest! ____________________________________________________________ Sustainable Business Network of the Inland Northwest 6021 E Mansfield, Spokane Valley, WA 99212 Phone: 509-720-8555 ~ E-mail:[email protected]

-- Membership Levels -1. Business Member The Business membership category is for independent, locally owned businesses, farms, and organizations which meet the criteria described on page 1. Business Members are fully entitled to all marketing, promotional, educational and other benefits offered as part of Sustainable Business Network of the Inland Northwest. Business membership dues are revenue dependent, please see page 1 for more information. 2. Sustaining Member -- $1000 A business member wishing to contribute more to the network to support our community and economy, sustaining members receive additional promotional materials and recognition for their support. 3. Community Partner---$1000 For organizations or individuals that don’t meet the criteria for business membership but still wish to support the network. Community partners receive recognition on the website and some promotional materials for their support of the local economy and community. 4. Affiliate---$100 Professionals or businesses in the area who do not own a local, independent business. Affiliate Members receive access to the networks educational and business support programs, but aren’t eligible for promotional and marketing materials. 5. Supporter---(any amount) We welcome the support of any individual or organization who wishes to help Sustainable Business Network of the Inland Northwest carry out our mission. Individuals donating $100 or more will receive recognition in some network materials, and supporters of $1000 and more will be recognized as Community Partners. Members of the Sustainable Business Network of the Inland Northwest share the following interests: a. Ensuring that our place doesn't become any place. b. A commitment to a strong community and thriving local economy with meaningful jobs, a diversity of business owners and involved citizens. c. A desire for public awareness about the importance of supporting local products, services and retail outlets. d. A commitment to decreasing negative impacts on our water, forests, and air. e. A desire to know and do business with others in the community who share similar concerns and values. f. A need for collaboration that helps reduce costs and increase convenience to make environmental and local business decisions. g. An interest in modeling sustainable practices for the community.

____________________________________________________________ Sustainable Business Network of the Inland Northwest 6021 E Mansfield, Spokane Valley, WA 99212 Phone: 509-720-8555 ~ E-mail:[email protected]