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Honorary Membership Application
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*Important*
Honorary Membership may be granted by the Board of Directors. Honorary Members shall not pay an admission fee, shall pay no dues and shall not be entitled to vote, but shall be entitled to all other privileges of an Active Member. Any Honorary Membership so granted may at any time be recalled by the Board of Directors. - Article IV: Section 8, of the CSEA Bylaws
Applicant's Name
*
First
Last
Business Name/dba
*
What is your current position and title?
*
Email
*
Cell Phone
*
Type of Business (select one)
*
Individual Sole Proprietor
Partnership
Corporation
Non Profit
Other
If partnership or corporation
please list all partners or principal officers
Nature of Business
*
Briefly describe what your company does. Please provide as much pertinent information as possible, as this will be used to help determine the business classification.
How long have you been associated with this business?
*
If less than two (2) years, what was your former occupation?
How long have you lived in Colorado Springs?
*
Additional Information
Please provide any additional information you feel would be helpful to the Board in consideration of this application.
Business Communication Information
Mailing Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Physical Address (if different)
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Applicant Digital Signature
*
Type your name here to sign your application
Submit