Business Name: (required)

Address: (required)

City: (required)

State:
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Zip Code: (required)

Phone: (required)

Fax:

First Name: (required)

Last Name: (required)

Title: (required)

Telephone: (required)

Extension

Email: (required)

Type of Business: (i.e.Fundraising, Apparel, Insurance)

Check the box that best describes your business:
ManufacturerRetailerBrokerDistributorFranchiseeRepresentative

Key Word Descriptions: (Words that describe your company or product)

List the products/services/programs (up to 3) that make your company a leader in your industry:

Tell us what makes your company special?

Is your company able to offer an ongoing special NBCTC Member discount for NBCTC referrals?
YesNo
(If Yes, please describe below)

Business write-up: (85 words or less)

Does your company have any sales restrictions?
YesNo
If Yes, please explain below.

How does your company currently market your products? (Check all that apply)
Company Sales RepsIndependent Sales RepsFranchiseesBrokersDirect MailEmailInternetTrade ShowsPrint MediaOther
(If other, please describe)

The NBCTC has established the Business Code of Ethical Standards to guide NBCTC members in their relationships with booster clubs. A condition of membership within the NBCTC involves a willingness to be guided by the NBCTC Business Code of Ethical Standards, which are a part of this application. These guidelines and your company's support of them may be publicized in an effort to bring support to the Code of Ethical Standards and your business.

Click Here to Review the Business Code of Ethical Standards
We pledge that our company has maintained, and will continue to maintain, the standards set forth in the NBCTC Business Code of Ethical Standards.

If you agree please initial here:

We understand that as a member of the NBCTC that our business website may be promoted and that our business agrees that it will abide with COPPA (Children's Online Privacy Protection Act).

If you agree please initial here:

Membership Dues are paid one-time, upon approval. Membership Dues are based on Gross Annual Sales. Click Here to see dues schedule.

Insert answers from Dues Chart below.

Gross Revenues: ( Dues Chart)
Select your Gross Annual SalesUp to $1,000,000$1,000,001 up to $3,000,000$3,000,001 up to $5,000,000$5,000,001 up to $10,000,000$10,000,001 and higher

Promotional Code: (if applicable)

If you have spoken to one of the NBCTC representatives, please take a moment to indicate which representative. Taking the time to do so will make it easier for us to provide you with the proper assistance in the future.

Were you referred by a NBCTC representative?
YesNo

NBCTC Representative Name:

A NBCTC staff member will contact you to discuss your submittal.