Business: ______________________________________
Key Contact: ____________________________________
Address: _______________________________________
City: ____________________ State: _________________
Zip: _____________ Phone: ________________________
Fax #: ___________________
E-mail: __________________
Web Site: ________________
Type of Business: _________________________________
No. of Employees: _____
What type of projects would interest You?
____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________
Investment Schedule
| __ |
Individuals and Seniors | $75.00 |
|
| __ |
Non-Profit Charitable, Government | $85.00 |
|
| __ |
Home-Based Business: Two or Less Employees | $105.00 |
|
| __ |
Independent Contractors | $105.00 |
|
| __ |
Business with one to four employees | $160.00 |
|
| __ |
Business with five to ten employees | $185.00 |
|
| __ |
Business with eleven or more employees | $330.00 |
|
| __ |
Patron | $500.00 |
Please print and mail the completed form shown above with your check payable to:
590 Winslow Way East
Bainbridge Island, WA 98110
Top
