Member InfoCompany Name*Website Contact Person* First Last Business Address* Street Address Unit / Suite Number City State Zip Code Your Email Address* Enter Email Confirm Email Your Phone*Best Time To Call You*When is the best time for us to reach you via telephone?Best Time To Call YouMorningsEarly AfternoonLate AfternoonEarly EveningBusiness InfoType of Business*Number of Years In Business*Number of Locations*Plan Type*Annual Plan = $200(Includes Main location of business on website, with map and Member window decal ) Each additional location (up to 6 total ) is $75.00 annuallyTerms and ConditionsBy agreeing to our terms, I certify that all of the information contained in this application is true and complete. All approved members agree that the views and opinions expressed by our members are those of the members and their establishments and do not necessarily reflect the official policy or position of Blue Line Business Network. I understand that Blue Line Business Network may seek to verify any or all information listed above or otherwise provided by me. I hereby expressly authorize Blue Line Business Network to verify that information, without further notice to or consent by me. I hereby release from liability Blue Line Business Network and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information. Blue Line Business Network is an Equal Opportunity Organization. Blue Line Business Network does not discriminate in memberships and no question on this application is used for the purpose of limiting or excusing any applicant’s consideration for membership on a basis prohibited by local, state or federal law. I have agreed to submit this application by electronic means. I understand the questions and statements on this application. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.Sign NameDate Acceptance* By checking this box and typing my name above, I am electronically signing my application and agreeing to terms and conditions of this form.