Nature Coast - Enterprise - Membership Application

Membership Application Form

Full name of person applying
Mandatory field Name*
Title of the above person
Title
Business Name
Mandatory field Street Address*
Postal Address
Mandatory field Phone Number*
Mandatory field Email*
Website
Number of full time staff (including owner)
Staff
Membership Category	Tier1 Tier2 Tier3 Tier4
I apply for membership of Enterprise Kapiti Horowhenua Incorporated, trading as Nature Coast Enterprise. If accepted, I agree to be bound by the Constitution and rules in matters relating to my membership. I am willing to let the details above be entered into the Nature Coast Enterprise database. NB: (Participation in the domestic marketing campaign is subject to achieving critical mass. If this is not achieved then tier 4 & 5 members will become tier 3 members and the difference refunded).
	yes no