Membership Application

To fill out the application offline and mail or deliver to SBMC, download the PDF

Name of Applicant*

Web Address

Name of Firm*

Email*

Birth Month and Day*

Spouse's First Name

Business Information

Address*

City*

State*

Zip*

Business Phone*

Type of Business*

If other, please specify:

Residence Information

Address*

City*

State*

Zip*

Residence Phone*

General Information

Mail to*

Cell Phone

Fax

Are YOU a property owner in South Jacksonville?*

Are YOU actively engaged in business in South Jacksonville?*

Who sponsored your application for membership?*

I hereby apply for membership in the Southside Business Men's Club certifying that I am a business person actively engaged in business or that I own property in Duval County south of the St. Johns River and that I am interested in Southside's continued growth and development. I will earnestly try to attend as many meetings as possible.

Type of Membership:*

Individual Membership

Individual Fee: $225
Plus one-time initiation fee: $50
Total fee: $275

Corporate Membership

Corporate Fee: $325
Plus one-time initiation fee: $50
Total fee: $375

Please indicate how you want your name and company listed on member badge:*

Alternate Member Information

Alternate Name*

Email*

Birth Month and Day*

Spouse's First Name

Residence Information

Address*

City*

State*

Zip*

Residence Phone*

General Information

Mail to*

Cell Phone

Fax

Are YOU a property owner in South Jacksonville?*

Are YOU actively engaged in business in South Jacksonville?*

Payment Information

First Name*

Last Name*

Email*

Address*

Address Line 2

City*

State*

Zip*

Credit Card Type*

Card Number*

Expiration Date*

CVV Security Code*