To join on-line please fill out the form below then click on Submit to be connected to PayPal.

RBA Business Application

• Business Name*
  Exactly as you’d like listed on websites
• Address*
  Street AddressCityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZip Code
• Business Phone*
• Cell Phone
• Email
• Website
• Contact Person*
  FirstLast
• 35-word description of business
  (may be edited)
• Days/Hours of Operations
  (or state if must be arranged by appointment)
• List your Special Offer for the coupon section and FIA Card
  (if you wish to make an offer)
• Select Your Roswell Partnership Level
  • $105.00 (1-2 full time employees)
  • $155.00 (3-10 full time employees)
  • $205.00 (10-15 full time employees)
  (Convenience Fee Added - The fee is $5.00 per transaction.)
  
  NOTE: Over 15 full time employees please contact the Membership Department at membership@roswellba.com or call 770-640-3253.
• OTHER CHOICES FOR PAYMENT:
  • $250 plus $8.00 process
  • $300 plus $9.00 processing fee
  • $500 plus $15.00 processing fee
  • $1000 plus $30.00 processing fee