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 Member Questionnaire 
Company Name:

Company Contact:

Type Of Business:

Address Line 1:

Address Line 2:

City:

State:
Zip:

         Phone:

Fax:

Email:

Website:

Number of Employees:

Year Company Established:


Company Information:
Please write a brief description of your company or business (around 50 words).

Are you interested in being a sponsor* of a WSBA member meeting? YES

Are you interested in serving on a WSBA committee? YES

Are you interested in writing an article on
your expertise or interest for the WSBA newsletter?
YES

Would you like to receive the newsletter electronically? YES





* Sponsoring a meeting consists of providing your products and/or other products or services for member drawings and/or door prizes. This provides an excellent way to get your business name out in front of other members.

West Side Business Association ~ 437 Cty Hwy M ~ Madison, WI 53719
Ph: 608-833-6355 ~ FAX: 608-833-6078 ~ wsbawsbamadison.com

  ©2006 Madison Computer Works, Inc.