Application Form - Family Business Association Atlantic

First Name ^*

Last Name ^*

I identify as...

Woman

Man

Transgender

Non-binary/non-confirming

I'd prefer not to answer.

We do research about gender & the work place/small business and would appreciate knowing how you identify. Please select all that apply.

Age ^*

Please select the your age range.

Email Address ^*

Professional Title

Address Details ^*

City ^*

State ^*

Postal Code ^*

Phone

Website

Facebook

About ^*

What generation do you represent in your family business? ^*

Please select the best description

Role ^*

In the family

Have ownership

Work in the company

Are you in the family? Do you have ownership? Work in the company? Please check all that apply.

How did you hear about FBA? ^*

Please select how your first heard about FBA.

What drew you to FBA? ^*

Join a Peer group

Networking

Education sessions

Family Business Resources

Access to the trusted advisors

Support a local Organization

Support family Businesses in my Region

Other

Please check all that apply.

Number of Employees ^*

Please enter the total number of employees at your company.

Annual Revenue ^*

Please select your company's annual revenue

Country ^*

Organizational Confidentiality & Non-solicitation

I agree

I disagree

I agree to respect the privacy of FBA members by keeping any information about fellow members found in the members area or discussed in a peer group confidential. I also understand that while FBA is a family of business organizations who support each other, I am not permitted to actively solicit business from other members. Relationships will develop between members over time but 'cold calling' is not permitted. Violation of this policy may result in dismissal from the organization. Our membership fees are non-refundable.

Company ^*

Membership Plan

Membership Plans

I accept terms of use and privacy policy.

Join Our Family!