Membership Application – Tri County Business Exchange

Basic Information

Email *

Applicant's full name *

Applicant's preferred name *

Business name *

Business category * (what you do — e.g. Real Estate Agent, Painter, CPA)

Your position (optional — your title at the business, e.g. Owner, Agent)

Business address *

Business phone *

Mobile phone *

Website *

Headshot Photo

Upload a headshot (optional — JPG, PNG, GIF, or WebP)

Experience and Credentials

Give a brief description of your business *

How long have you been in this profession? *

Education background, current licenses and their number, and/or credentials required for this business *

Has your professional license and/or certificate been revoked or suspended? *

No Yes

If Yes, why? (optional)

Standards and Expectations

Are you able and willing to commit to weekly 90 min meetings, make our socials, and agree to our code of conduct? *

Yes No

If unable to attend a meeting, are you willing to send a substitute? *

Yes No

Are you willing to bring referrals to our group? *

Yes No

Do you belong to any other networking groups? *

Yes No

If yes, please provide the names of the groups (optional)

Membership Dues

How would you like to be billed for your membership dues? *

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Dues are billed by invoice from the Tri County Business Exchange. If you are accepted, the accounting team will confirm your billing details before your first invoice.

Code of Ethics

Give First, Ask Second.
Attendance: Up to 6 absences over a rolling 6-month window. Up to 6 subs allowed over a 6-month window.
Everyone Participates: If you are not actively involved, you will be asked to step up or step out (referrals, one-to-ones, active in the meeting).

Do you agree to the code of ethics? *

Yes No

Business References

Please provide 2 business references. Let them know they may be contacted for a reference check.

Business Reference #1 — Name, Position, Business Relationship *

Reference #1 phone number *

Reference #1 email *

Business Reference #2 — Name, Position, Business Relationship *

Reference #2 phone number *

Reference #2 email *

Social Media

Please provide any links to your social media accounts. (all optional)

Facebook

Instagram

X (Twitter)

Other

Survey

How did you hear about Tri County Business Exchange? *

Why are you interested in joining Tri County Business Exchange? *

What are your long-term hopes and goals related to Tri County Business Exchange? *

Please share your personal interests, hobbies and passions (optional)