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027 490 4260

Business West Affiliated Member Form

For Business West – Business Association Inc. (BWBA) Business Improvement District (BID) Members.

Companies situated within the BWBA (BID) Boundary. If your Business and/or Property pays the BID targeted rate, then both are automatically a ‘BID Affiliated Member’ BID policy requires BWBA to seek your registration.

PLEASE NOTE:

You need to be a Company Director, CEO, General Manager or Business Owner to fill in this form.

Owner($0.00)

Owner($0.00)

Select Membership Plan

Select Child Users

5

5
10
15
20
25
30
35
40
45
50

Personal Details

* To complete this form, your position in your organisation must be one of the following options.

Please select an option
Company Director
CEO
General Manager
Business Owner

* To complete this form, your position in your organisation must be one of the following options.

* First Name (CEO/GM or Co. Director, Business Owner)

* Last Name (CEO/GM or Co. Director, Business Owner)

* Email (CEO/GM or Co. Director, Business Owner)

* DDI Phone Number (CEO/GM or Co. Director)*

* Mobile Phone Number (CEO/GM or Co. Director, Business Owner)

Business Details

* Company Name (Ltd)/Organisation Name

* Trading Name

* Company Slug

* Website (URL)

* Industry/Sector

Please select an option
Banking and Business Services
Building and Construction
Educational and Training
Employment and Recruitment
Health and Wellbeing
Hospitality
Manufacturing
Motoring
Professional Services
Recreation and Community
Retail and Wholesale
Trades and Trade Services
Foundation Member

* Industry/Sector

* Business Main Contact Phone Number

* Street Address

* Postal Code

* City

Postal Address (if different from above)

Post Code - Postal Address

Logo

(Use Cropper to set image and
use mouse scroller for zoom image.)

(Use Cropper to set image and use mouse scroller for zoom image.)

Drop image here or click to select.

Gallery Images

Drop image here or click to select.

List in "Our Members" Directory?

No

Yes

Do not show street address in profile

No

Yes

Are you ConnectHer Affiliated?

Yes

No

Gender

Male

Female

NA

Your Password for Business West Portal

* Password For Portal Login

Strength: Very Weak

Consents & Privacy

* Public Member Directory Consent

I consent to the publication of our business details in all Business West directories.

* Marketing communications

I agree to receive other communications from Business West.

* Data processing

I agree to allow Business West to store and process my personal data.

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

Already have an account? Login

Owner($0.00)

Owner($0.00)

Select Membership Plan

Select Child Users

5

5
10
15
20
25
30
35
40
45
50

Personal Details

* To complete this form, your position in your organisation must be one of the following options.

Please select an option
Company Director
CEO
General Manager
Business Owner

* To complete this form, your position in your organisation must be one of the following options.

* First Name (CEO/GM or Co. Director, Business Owner)

* Last Name (CEO/GM or Co. Director, Business Owner)

* Email (CEO/GM or Co. Director, Business Owner)

* DDI Phone Number (CEO/GM or Co. Director)*

* Mobile Phone Number (CEO/GM or Co. Director, Business Owner)

Business Details

* Company Name (Ltd)/Organisation Name

* Trading Name

* Company Slug

* Website (URL)

* Industry/Sector

Please select an option
Banking and Business Services
Building and Construction
Educational and Training
Employment and Recruitment
Health and Wellbeing
Hospitality
Manufacturing
Motoring
Professional Services
Recreation and Community
Retail and Wholesale
Trades and Trade Services
Foundation Member

* Industry/Sector

* Business Main Contact Phone Number

* Street Address

* Postal Code

* City

Postal Address (if different from above)

Post Code - Postal Address

Logo

Drop image here or click to select.

Gallery Images

Drop image here or click to select.

List in "Our Members" Directory?

No

Yes

Do not show street address in profile

No

Yes

Are you ConnectHer Affiliated?

Yes

No

Gender

Male

Female

NA

Your Password for Business West Portal

* Password For Portal Login

Strength: Very Weak

Consents & Privacy

* Public Member Directory Consent

I consent to the publication of our business details in all Business West directories.

* Marketing communications

I agree to receive other communications from Business West.

* Data processing

I agree to allow Business West to store and process my personal data.

You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

Already have an account? Login

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