BUSINESS NAME: ______________________________________________________

ADDRESS:  ______________________________________________________

MAILING ADDRESS:  ___________________________________________________

PHONE: _______________________   FAX: _________________________________

E-MAIL ADDRESS: _____________________________________________________

CONTACT PERSON _________________________TITLE: __________________

I am enclosing the following dues as my renewal in the Bella Vista Business Association for the 2011 calendar year.

Please check one of the following:

_________ $75.00 for membership dues only.  I will not be participating in the Business Fair.

_________ $150.00 for membership dues and Business Fair participation fee.

_________ $10.00 to be added to membership dues if you require a power source for the Business Fair.

SPACE IS LIMITED AS WE WILL NOT BE USING THE CRAFT ROOM AT RIORDAN HALL.  ACTIVE MEMBERS WILL BE GIVEN FIRST PRIORITY ON AVAILABLE SPACE ON FIRST COME, FIRST SERVED BASIS.  IN ORDER TO BE LISTED IN THE 2011 MEMBERSHIP DIRECTORY AND TO RESERVE YOUR BOOTH SPACE IF YOU WISH TO PARTICIPATE IN THE FAIR, IT IS IMPERATIVE THAT DUES BE RECEIVED ON OR BEFORE JANUARY 31, 2011.

PLEASE SEND COMPLETED FORM AND DUES CHECK TO:

TREASURER

BELLA VISTA BUSINESS ASSOCIATION

P. O. BOX 5366

BELLA VISTA, AR 72714