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Membership Application

Please fill out all required fields. A DavenportOne staff person will review your application and be in touch. You will be invoiced once your application is accepted.

Business Information * indicates required field

Company Name :*

 

Established in :

Physical Address :*

 

City:*

 

State :*

 

ZIP :*

 

Telephone :*

 

Fax :

E-mail :

Web Site :

Mailing Address (if different) :

Billing Address (if different) :

 

Main Contact :*

  One mailing contact for every $100 in membership dues. Each additional contact is $10.

Title :*

Email :*

Mailing List :

Yes No

Who's Who :

Yes No
 

Second Contact :

 

Title :

Email :

Mailing List :

Yes No

Who's Who :

Yes No
 

Third Contact :

 

Title :

Email :

Mailing List :

Yes No

Who's Who :

Yes No
 

Business Category :

Total Number of Employees :

Full-Time :

Part-Time :

Each part-time employee is calculated as 1/2 a full-time employee.

Dues Investment :

A $35 one-time administration fee is charged to each new member business.

Website & Email hotlinks:

Yes A $20 annual fee will be on final invoice.

Redeem D1 Dollars :

Yes No  
New Member Profile :

(Please write a 35-word profile about your business for use in the DavenportOne monthly newsletter.)


NOTE: Your "New Member Profile" will be read by nearly 2,500 business and professional people. Please do not release information you do not want published. DavenportOne reserves the right to refuse any profile. DavenportOne reserves the right to edit any "New Member Profile." It is the ultimate responsibility of the member to make sure they submit a profile for inclusion and that it is accurate and free of grammatical and/or spelling errors. Profiles will be printed in the newsletter on a first come, first serve basis. Please return your profile to DavenportOne. The deadline for each month is the 15th of the preceding month.
Thank you for your interest! A DavenportOne staffer will be in touch.

  


DavenportOne 130 W. Second St., Davenport, IA 52801 :: 563-322-1706