Membership Application Membership is open to all veteran owned and service disabled veteran owned small businesses. Associate, Supporting memberships are available to other types of businesses who wish to support the NVSBC mission. CORPORATE INFORMATION Company Name Corporate Address City State Zip Code Phone Number Email Address Website/URL SB Certifications VA Verified SDVOSB VOSB WOSB HubZone 8(a) SDB EDWOSB INDUSTRY GROUP Construction A/E IT Manufacturing Medical Manufacturing Distribution Services Other (specify) INDUSTRY GROUP OTHER If Other Please Specify below Specify PRIMARY REPRESENTATIVE TO NVSBC (Website login credentials will be sent to each representative 3 -4 days after receipt of application) NVSBC membership resides with the company, not the representative. Primary Representative Name 1 First, Middle Initial, Last Primary Representative Address 1 (if different from above) Primary Representative Email Address 1 Primary Representative Phone Number 1 123-456-7890 Primary Representative Name 2 First, Middle Initial, Last Primary Representative Address 2 (If different from above) Primary Representative Email Address 2 Primary Representative Phone Number 2 123-456-7890 Billing Contact Name First, Middle Initial, Last Billing Contact Email ANNUAL DUES Membership year is January 1 through December 31st regardless of when you join. Only “Members” have voting privileges. Members Small, veteran-owned or service disabled veteran owned business ($350) Small, veteran-owned or service disabled veteran owned businesses which are large under their primary NAICS code but have 1,500 employees or less ($1200) Associate Members Mid-Tier – non-veteran owned business with 1,500 employees or less ($1200) Other Small Businesses – non-veteran-owned federal government contractors. Must be owned by U.S. citizens and small based upon their Primary NAICS Code size standard ($575) Supporting Members Non profit organizations, agencies, or departments of the federal government ($575) PTACS ($60) Large Businesses ($2,400) Chapter Affiliation Colorado Chapter DC Metro Chapter Central Florida Chapter Mid Atlantic Chapter South Florida Chapter No NVSBC Chapter In the Area/Region How did you find out about the NVSBC? Member's Authorized Representative AGREEMENT TO TERMS AND CONDITIONS OF MEMBERSHIP The undersigned pledges to pay membership dues according to the scale listed above and attests to the size status for the company they represent. The Member Company also agrees to abide by all terms and conditions of membership as may be set forth in NVSBC's by-laws or organizational documents or established by the Board of Directors. The Member understands that its failure to pay membership dues timely, or comply with the terms and conditions of membership can result in termination of the membership. (Please note that only “Members” who have paid membership dues have voting privileges through their designated representative.) 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