Application  for Membership

To the NEBBA Board of Directors:

I, the undersigned, hereby apply for membership in the New England Business Brokers Association ("NEBBA").  I give my permission for NEBBA to verify information I have provided herein.  Should I be accepted into membership, I promise to uphold the Bylaws and Code of Ethics of NEBBA and to support the organization through my regular attendance in  NEBBA activities.

Membership Type:  Individual-$125 Associate-$50 Company-$125 Affiliate-$125 (Select One)

New or Renewal New-Include $75 Initiation Fee Renewal

Applicant's Name 

Home Address Street

City  State  ZIP

Firm Name 

Street Address 

Address Line 2

City          State   

Zip

Telephone    Facsimile

Email 

Website 

Number of Associates 

Year Established

Specialty

Affiliations & Designations

Description of Services

References:  (must include 2 NEBBA Company Members)

1.  Name

 Relationship: 

City State Zip

 Telephone

2.  Name

Relationship: 

City State Zip

 Telephone

3.   Name

 Relationship: 

City State Zip

 Telephone

4.  Name

Relationship: 

City State Zip

 Telephone

Please print the confirmation  page (after you click submit at the bottom of this page), sign and return with a check for $200 ($125 annual dues; $75 initiation fee) payable to the New England Business Brokers Association.  Your application will be reviewed by the Board of Directors for consideration at the monthly meeting following receipt.  (Subject to quorum requirements.)  In the event that your application is not favorably considered, this check will be returned to you. 

The application and check should be returned to:

Tel. 978-263-5559