Brickell Area Association

Membership Information Form

Name of Business:

Last Name:

First Name:

Title:

Type of Business:

Number of Employees:

Telephone Number:

Fax Number:

E-mail Address:

Mailing Address:

City:

State:

Zip:

Type of Membership (Check One) :

Trustee (Entitles Member to Board of Directors Seat)	$1,000
Large Employer (50+ employees) or Commercial Property Owner	$500
Associate Member (All BAA Others)	$200
Out-of-Area Member	$300

Preference of Committee Participation (Check One) :

Preference of Committee Participation (Check One)
Beautification
Transportation
Marketing & Publicity
Newsletter
Retail

Brickell Village Redevelopment
Land Use/PLanning & Zoning
Membership
Park & Schools
Special Events

Describe below any activities or areas of interest to you and your company not listed above:

How did you learn about the Brickell Area Association?

What are your primary reasons and objectives for joining the Brickell Area Association?

We DO DO NOT (Please select one) want to be listed in the BAA Webpage Membership Directory located at http://www.brickellarea.com.

Make dues check payable to Brickell Area Association and return with completed Membership Information From to:

Brickell Area Association
777 Brickell Avenue, Suite 808
Miami, Florida 33131