EBCA Membership Form
Business Member $75 • Community Member $50
Fees may be mailed to EBCA, PO Box 662, Enosburg Falls VT 05450
or via PayPal Link: https://www.paypal.com/paypalme/EBA933
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Date: *
MM
/
DD
/
YYYY
Business or Individual Name *
Primary Contact *
Contact Email Address *
Business Email Address (If Different)
Phone Number
Physical Address
Mailing Address (Leave blank if It's the same as physical)
Hours of Operation
Website Address
Social Media Accounts
Years in Business
The EBA could use your help! Please check as many boxes for events that you would be interested in volunteering for:
Suggestions for our organization
What is the best meeting time for you? *
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