Please mail Membership Application to:
Membership Committee
Spokane Referral Network
5407 S. Lloyd
Spokane, WA 99223

MEMBERSHIP APPLICATION

SPOKANE

REFERRAL

NETWORK

New Member dues: $150          Renewal Dues: $100          Quarterly Dues: $5.00 per week

Please attach your busines card

Last Name: __________________________________________________________

First: ________________________________________________________________

Employer Name: _____________________________________________________

Employer Address: ___________________________________________________

Phone: _________________________  Fax: ________________________________

Email: ________________________________________________________________

Occupation: __________________________________________________________

Franchise Owner?    Yes ____     No ____

How long in business? ________________________________________________

Date: _________________________________________________________________

Signature: ____________________________________________________________

Sponsor Name: _______________________________________________________

Inspection Report

1. Are you willing to support each member of the group?
2. By applying for membership in this group, you are asking its members to extend loyalty to you in the form of referrals. Are you willing to make the same commitment to other members?
3. Do you understand that you are encouraged to invite guests to our meetings and encourage them to join?
4. What types of businesses would you like to see represented in the group?
5. What profession would you be able to refer to repeatedly because of your profession?

Date: _________________________________________________________________

Applicant Signature: __________________________________________________

Insector Signature: ____________________________________________________