ONLINE APPLICATION & PLEDGE

ABOUT US
CERTIFICATION
- CERTIFICATION CENTER
EVENTS & TRAINING
CORPORATE MEMBERSHIP
FAQs
NEWS

888-860-3074

info@wbecorv.org

5325 Deerfield Blvd.

Mason, OH 45040

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Call 513-957-3999

ABOUT US
CERTIFICATION
- CERTIFICATION CENTER
EVENTS & TRAINING
CORPORATE MEMBERSHIP
FAQs
NEWS

ONLINE APPLICATION & PLEDGE FORM

CORPORATE MEMBERSHIP APPLICATION

Online Application & Pledge

Company Name (Required)

Primary Contact Name (Required)

Field label

Title

Address (Required)

Address Line 2

City

State/Province/Region

Phone (Required)

Email (Required)

Secondary Contact

Last Name

Fax

Secondary Title

Secondary Contact: Phone

Secondary Contact: Email

Free Text

*Both Primary and Secondary Contacts will receive the monthly WBEC ORV newsletter.

Who should be listed in the online WBENCLink database accessed by WBEC ORV Region WBE's?

Preferred WBENCLink Username (Required)

Preferred WBENCLink Password (Required)

Free Text

Online Information

Website Address

May WBEC ORV link your site?

Yes

No

Free Text

Contact For Website Information and Logo Usage

Name

Name

First Name

Last Name

Phone Number

Email

Will you link WBEC ORV to your supplier information page on your website?

Yes

No

Select any WBENC affiliate organization of which you are currently a member

Women's Business Enterprise Council - Pacific

Center for Women and Enterprises

Great Lakes Women's Business Council

Greater Women's Business Council

Women's Presidents' Educational Organization - DC

Women's Presidents' Educational Organization - NY

Women's Business Council - Southwest

Women's Business Enterprise Council - South

Women's Business Development Center - Midwest

Women's Business Development Council of Florida

Women's Business Enterprise Center - East

Women's Business Enterprise Alliance

Women's Business Enterprise Council - West

WBENC National Corporate Member

Free Text

Other Information

Do you currently have a supplier diversity program for women-owned business? (Required)

Yes

No

Can you provide in-kind support to WBEC ORV? (Required)

Yes

No

Industry

Products Produced

Products Purchased

Description of Service Provided

Dues Structure: Annual WBEC ORV Dues (Required)

$2,500 Corporate

$1,750 Non-Profit, Government

Consent (Required)

I understand and agree to the following:

Free Text

I UNDERSTAND THAT THIS APPLICATION IS CONSIDERED A COMMITMENT AND THAT MY CORPORATION WILL START RECEIVING MEMBERSHIP BENEFITS ACCORDING TO THE DATE MY APPLICATION IS RECEIVED.

Authorizing Signature (Required)

Company

Date (Required)

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We’d love to hear from you. Call us at 888-860-3074 or send us a message using the form below and we’ll get back to you as soon as we can.

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Phone:

Message:

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Women's Business Enterprise Council Ohio River Valley (WBEC ORV)

5325 Deerfield Blvd.

Mason, OH 45040

888-860-3074

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