BizFed - New Non- Profit Business Association Membership Form

Membership Region

Regional Membership Choice*

Please choose which Regional BizFed you are applying for membership to. Choosing both will mean paying double the membership fees

Los Angeles County
Central Valley
Both

Member Information

Association Name*

Business Address*

Business City*

Business State*

Business ZIP*

Enter a Mailing Address below, if different from your Business Address.

Mailing Address

mailing city

mailing state

mailing zip

Company Phone*

Company Website*

Number of Members*

Type of Business Association

Primary Contact - Los Angeles

Primary Contact Name*

Professional Title*

Business Association*

Phone Number*

Email Address*

Select Committees

Additional Contacts - Los Angeles

Designate up to four additional people to be engaged.

Contact #2 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

Contact #3 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

Contact #4 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

Contact #5 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

Does your organization have a Political Action Committee (PAC)?

Yes
No

Enter name of PAC

Does your organization have a Foundation (c3)?

Yes
No

Enter name of Foundation

Please Provide Logo for BizFed Website/Marketing Materials

Primary Contact - Central Valley

Primary Contact Name*

Professional Title*

Business Association*

Phone Number*

Email Address*

Select Committees

San Joaquin Valley Air Pollution Control District Committee

Additional Contacts - Central Valley

Designate up to four additional people to be engaged.

Contact #2 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

San Joaquin Valley Air Pollution Control District Committee

Contact #3 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

San Joaquin Valley Air Pollution Control District Committee

Contact #4 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

San Joaquin Valley Air Pollution Control District Committee

Contact #5 Name

Professional Title

Business Association

Phone Number

Email Address

Select Committees

San Joaquin Valley Air Pollution control District Committee

Does your organization have a Political Action Committee (PAC)?

Yes
No

Enter name of PAC

Does your organization have a Foundation (c3)?

Yes
No

Enter name of Foundation

Membership Level

Please choose from one of the membership levels below. Membership dues are based on yearly revenue and Basic/Elite status. Choosing Elite gives organization special recognition in BizFed brochure materials and at board meetings.

Revenue Less than $100,000

Revenue - $100,000 - $500,000

Revenue - $500,000 - $1,500,000

Revenue - $1,500,000 - $3,000,000

Revenue - more than $3,000,000

Please Provide Logo for BizFed Website/Marketing Materials

Payment method*

Mail a check
Paypal

Please mail the check to:
BizFed, Los Angeles County Business Federation
6055 E. Washington Blvd #1005
Commerce, CA 90040
Tax ID#26-0295348
BizFed W9 Form

Los Angeles County Membership Agreement

All members of BizFed agree to the following requirements:

501 (c) association serving business members with interests in Los Angeles County
Supports the overall vision, goals and strategies of BizFed as outlined in the organization’s bylaws and strategic plan.
Agree to send "Action Alerts" to your members within 48 hours, unless the requested action conflicts with your association's position.
Agree to keep any list of BizFed member contact information confidential and used only for the purpose of organizing around BizFed issues.

Membership Criteria*

I agree to membership criteria

Type your full name as your signature*

Enter today’s date*

Central Valley Membership Agreement

All members of BizFed agree to the following requirements:

501 (c) association serving business members with interests in Central Valley
Supports the overall vision, goals and strategies of BizFed as outlined in the organization’s bylaws and strategic plan.
Agree to send "Action Alerts" to your members within 48 hours, unless the requested action conflicts with your association's position.
Agree to keep any list of BizFed member contact information confidential and used only for the purpose of organizing around BizFed issues.

Membership Criteria*

I agree to membership criteria

Type your full name as your signature*

Enter today’s date*

Have questions?

Please contact Robert Duarte, Operations & Projects Manager

Robert Duarte
Email: Robert.Duarte@BizFed.org
Phone: 323.889.4348