MEMBERSHIP APPLICATION

Thank you for your interest in becoming a member of the Family Business Forum.

 

Please complete and submit the form below, or download a PDF copy and mail your completed application with payment (made payable to Family Business Forum at King's College) to:

 

Family Business Forum

King’s College

The William G. McGowan School of Business

133 North River Street

Wilkes-Barre, Pennsylvania 18711

 

Contact us if you have any questions. All information is strictly confidential.
Company Name:
President/CEO:
Contact Person:
         Position: 
Address:
City:
State:
             Zip:
Website:
Telephone:
 ( ) -    Fax:  ( ) -
E-mail:
Founder of Business:
          Year Founded: 
Total # of Employees:
Product or Services:
   

List all family members and key non-family employees that should receive notices of Forum programs:

Name:
Name:
Title:
Title:
E-mail:
E-mail:
     
Name:
Name:
Title:
Title:
E-mail:
E-mail:
     
Name:
Name:
Title:
Title:
E-mail:
E-mail:


Membership Levels
Please select the appropriate membership level:
Full Membership: $1200 annual membership fee entitles an unlimited number of participants to attend all programs.
 

Special Small Business rate for firms with fewer than 10 employees:

 $ 500
       
Supporting Membership: An annual fee of $2000, offers additional support to the FBF as a community based effort to enhance the success and succession of the many family owned businesses in Northeast Pennsylvania. Supporting members enjoy all the benefits of full membership.
   
Method of Payment:
  Invoice me
  I will forward payment to the FBF
     (checks are made payable to the Family Business Forum at King's College).
  Call me to obtain credit card information