Member Application
Business Information
Company Name:
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Phone:
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Website:
Email:
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Business Description (200 char max):
Directory Category:
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--- Select Primary Category ---
ABA Autism Center
ABA Therapy
Accountants
Adult Day Care
Advertising
Agriculture
Apartments
Apparel/Promotional Items
Applied Behavior Analysis (ABA)
Appraiser
Architect
Art Gallery-Studio
Arts Education
Asphalt/Paving Contractor
Assisted Living
Associate Member
Attorneys
Automotive
Bakery
Banks & Credit Unions
Banquet Facility
Beauty Salon
Bed & Breakfasts
Boarding Kennel
Bookstore
Boutique
Boxes
Building Materials
Business Association
Campground
Cancer Services
Carpet
Caterers
Chambers of Commerce
Chauffeur Services
Chiropractor
Churches
Clinics
Commercial Developers
Commercial Printing
Community Services
Computer Service/Sales
Condominium Association
Construction Management
Consultants
Contractors
Convenience Store
Counseling
Dental Care
Diagnostic Imaging
Document Destruction
Drinking Systems, Softeners
Education
Electrical
Embroidery
Engineering
Engraving
Ethanol
Exercise & Physical Fitness Program
Fax
Financial & Investments
Fire & Water Damage Restoration
Fire Extinguishers & Protection Systems & Life Safety Equipment
Flags
Flooring
Florists
Food Bank
Funeral Services
Garage Doors & Openers
Gasoline & Diesel Fuel
Gift Shop & Specialty Items
Golf Course
Government
Graphic Design
Grocer
Group Benefits
Guns
Hardware
Heating & Cooling/HVAC
Home Care
Home Furnishings
Hospice
Hospital
Hotel
Housing & Urban Development
Human Resource Services
Insurance Agents
Internet Services
Janitor & Restaurant Supplies
Janitorial Service
Key Making
Kiosks
Lawn & Garden Dealer (tractors, lawn mowers)
Lighting
Livestock Farms
Machine Shop
Machinery Equipment & Supplies
Machinery Manufacturer
Maintenance Service
Manufacturing
Massage Therapy
Medical Care
Membership Organization
Mortgage Specialists
Newspaper
Non-Profit
Nursing Care
Office Equipment, Furniture & Supplies
Ophthalmology
Optical Services
Orchestra
Orthodonist
Paper Distributor
Performing Arts
Pest Control
Pets
Photographers
Plumbing
Preschool
Printing & Typesetting Services
Property & Casualty
Property Maintenance
Public Library
Quilting
Racing
Radiation Oncology
Radio Equipment
Radio Station
Real Estate
Recovery/Sober Living
Recycling
Rehabilitation Service
Relocation Service
Rental Service
Restaurants
Retail
Retirement Community
Rod & Custom Show
Roofing
Salt Delivery
Satellite Equipment & Cable Services
School
Security Services
Self Beauty
Senior Living Community
Sheet Metal
Shipping Service
Signs & Banners
Snow Removal Equipment & Services
Sound Engineer
Sound Systems
Stone, Sand & Gravel
Storage
Surveyors
Tax Return Preparation
Telephone
Theatre
Title & Abstract
Tourist Information
Trash Hauling
Travel Agency
Trucking
Utilities
Veterinarians
Video Production
Water Well Driller
Well & Pump Service & Repairs
Wholesale
Wholistic Health
Window Washing
Youth Organizations
Employees:
Full-time
Part-time
Comments / Questions:
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Business Established:
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Corporation
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Market Served:
Local
Regional
State
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Recommended By:
Physical Address
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Latin America
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Myanmar
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Romania
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Singapore
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South Africa
South Sudan
Spain
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Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Mailing Address
Same as physical address
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Line 2:
City:
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State:
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Postal Code:
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Country:
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--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Primary Contact Information
First Name:
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Last Name:
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Phone:
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Email:
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Contact Preference:
Email
Phone
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Password:
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Address
Same as Member Address
Line 1:
Line 2
City:
State:
Postal Code:
Country:
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Membership Options
Membership Package:
*
Connect
:
$250.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Enhance
:
$500.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Energize
:
$1,250.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Advocate
:
$2,500.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Influencer
:
$5,000.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Visionary
:
$8,500.00
Benefits associated with this level of membership and all other levels can be found here: https://www.gogreatergrant.org/investor-benefits/
Not sure.
:
$0.00
I'm not sure yet which level I'd like to invest. Please reach out to discuss my options!
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