GFBPA  MEMBERSHIP APPLICATION

"The Great Falls Business and Professional Association was founded for the purpose of advancing the business, professional and community welfare in the Great Falls area through activities that encourage Great Falls residents to use the business and professional services offered by the Great Falls business and professional people and by maintaining high business and professional ethics and practices in the community."

Association meetings are held 6 times a year at a local restaurant in Great Falls, Va. Membership applications can be mailed to prospective members upon request. Call Ralph Lazaro, President 703-759-3011 or Stephen Dulaney VicePresident 703-759-4155 for further details or email Stephen Dulaney

Mailing address:

Great Falls Business and Professional Association 

P.O. Box 1454  Great Falls, Virginia 22066

*Print, complete, sign and send via regular mail. We will contact you soon.

_____________________________________________________________________________________________________________________________

Application for  Membership *                                        Date _______________                       Sponsored by : ___________________________

Dues Amount Attached    $ 125.00  per year; payable to G.F.B.P.A.   

Profession or Business Name: ___________________________________________________________

Business Address: ____________________________________________________________________

Type of Business: _____________________________________________________________________

Business Phone:     (      )

Person to be contacted: _________________________________________   Preferred name: _________________________________________   

E-Mail Address: __________________________________      Website Address: __________________________________   

Office Telephone: (      )                   Fax:  (      )

Home Address:  _______________________________________________________________________

Home Phone: (      )                           Cell Phone:  (      )

Name of Spouse _____________________________________________________________________

Authorized Signature: __________________________         Title ________________________________________

 I'm interested in serving on one of the GFBPA committees  ______ (check)   A member of one of our committees will be in touch, Thank you.