Membership Application Form

Lakewood Ranch Business Leaders membership is non-competitive, we only enroll one firm from each business category. Members are expected to attend meetings, pay dues, and participate in
networking activities.

If you are interested in joining the group please complete the following online form. A one-time initiation fee $50.00 is required to be mailed after application is submitted. Check will be returned if for any reason membership is not granted. Only application accompanied by check will be considered.

After submitting this form please mail $50 check to:
Lakewood Ranch Business Leaders
c/o Steve Danyi, Treasurer
P O Box 48684
Sarasota, FL 34230

Applicants business category is checked against our current membership, approved by the board and membership.
Quarterly dues are $30.00 billed and paid yearly and are payable on acceptance by the board.

* Note: e-mail is a required field.

Name:
Title:
Business Name:
Business Type:
Address:
Address 2:
City:
Zip Code:
Email Address:
Wed Address
Telephone #:
Fax #:
Comments: