2011 WCBA Membership Renewal and Registration

2011 Membership dues are $30 per primary business and $10 for each additional business.
To be included in the WCBA Annual Membership Publication, WCBA must receive payment by February 28, 2011.
Please make checks payable to WCBA.
The 2011 Quick Guide will be redesigned to include business listings, destinations in Wayne County, and a Wayne County map.
This form is best printed in Landscape mode

Contact Name:Phone
(if different from business phone):


Cell Phone (optional)


 Address
(if different from business address)		 Email
(if you want WCBA to send info to this email address instead of your business):


Business Name Business Phone Business address Email
(to receive WCBA email)		 Business Category Amount
#1     $30
#2     $10
#3     $10
#4     $10
TOTAL    $


Please mail completed form and payment to PO Box 44, Teasdale, UT 84773

WCBA will contact you upon receipt of payment for details regarding your business listing on our website and in publications