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	Membership Application

Please complete the following South Omaha Business Association (SOBA) membership application. There are two sections on the form:

General company and contact information as it will appear in our online directory

SOBA Representative information (only if different from above)

Upon review of your application by the SOBA Board of Directors, you will be notified regarding your status as a member. Arrangements will be made for collecting your annual dues of $75.

(* Indicates required fields. Several input fields have a button to further clarify what is being requested.)

Company Information (as it will appear in our Online Directory)

Organization type:

* Company name:
* Address 1:
Address 2:
* City:
* State:
* Zip code:
Company phone:	(nnn) nnn-nnnn
Company email:
Website (URL):
Contact first name:
Contact last name:
Title/position:
Description (English):
Description (Spanish):

Company's SOBA Representative (ONLY IF DIFFERENT FROM ABOVE)
First name:
Last name:
Title/position:
Address 1:
Address 2:
City:
State:
Zip code:
Phone:
Phone extension:
Email:
* Reason(s) for requesting SOBA membership:


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