Business Member Application

Please fill in the following form to create an account on our web site. This is a two step process. * = Required Field

1. Enter your contact information in the form below and press “submit”.

2. An email with activation instructions will be sent to the address you provided below.

Primary Contact First Name * Primary Contact Last Name *   Business Owner General Manager

Company *

Website

Address 1 * Address 2

City * State * Zip * County *

Phone * Cell

Best time and method of contacting you?

Email Address *

Verify Email Address *

Password *

How did you find out about SIBG?

Did you work with an SIBG Agent? * Yes No

Please describe your business

The following questions will help us provide you a higher level of service.

Do you own or lease your building? * Own Lease

Does your business take credit and/or debit cards? * Yes No

Number of Full Time Employees? * Select 1-10 11-25 25-50 50-250

How long have you been in business? * Select 1-3 years 3-5 years 5-10 years Over 10 years

Please indicate the areas in which savings are important to your business? Credit Card Processing Printing Apparel/Uniforms Payroll Legal Promotional Products Utilities Accounting Non-Bank Lending S.E.O. (Google Advertising) Healthcare Franchising

What areas of your business would you like assistance or help with?