The Business Alliance : Uniting LGBT Business Owners, Professionals, Individuals & Allies

The Business Alliance
c/o OutReach 600 Williamson St. Madison, WI 53703
Date: __________________

1. Please choose your 12-month membership level

Individual Membership . . . . .? $60
Shows your support for the Business Alliance and Professional Businesses
• Invitations to all events
• Free admission to networking social events

Business / Professional Membership . . . . . . .? $95
• Invitations to all events
• Free admission to networking events
• Opportunity to host a monthly Meet & Greet
• Business Name listed on the Business Alliance web site with a link to your business web site
• Business Name listed on Social/Professional Networking web sites including:
o Live Space
o Plaxo (Exclusive to members)
o Linked-In
o Facebook

2. Individual contact information (for our records)

Name: _______________________________________________

Phone (work): _________________________(home): _________________

Mailing Address: _______________________________________________

City: ___________________________________________

State: ____ Zip: ___________________

Email: __________________________________________

3. Business / Professional members (available through the Business Alliance Web site.)

Company: ____________________________________________

Name: _______________________________________________

Phone (work): _________________________

Title: ________________________________________________

Mailing Address: _______________________________________________________________

City: ___________________________________________

State: ____ Zip: ___________________

Email: __________________________________________

Web: ________________________________

Please make checks payable to OutReach, Inc., and mail to:
Business Alliance • c/o OutReach • 600 Williamson St • Madison, WI 53703