SBC Membership Application
Thank you for applying for membership with Southern Business Connections.
We apologise we are currently experiencing technical difficulties with the use of this online application form. Please email SBC Chair Greg Garrihy: email@example.com to receive an application form to fill out. We apologise for this inconvenience.
Once your application has been received, instructions for payment of membership fees will then be sent separately. On receipt of payment your membership will be confirmed and your details will be listed on the SBC website.
If you have any questions please contact the SBC Business Facilitator, via firstname.lastname@example.org.
1 Mandatory SBC Membership Info2 Optional SBC Directory Info
Application Type: Annual Investment currently $80 standard membership (half year), $150 Corporate Membership (half year), which is valid until the end of the 2017/2018 financial year.* Existing Member (Renewal or Data Update)New Membership of Standard Membership of $80 per Half Financial YearNew Membership of Corporate Membership of $150 per Half Financial YearNew Gold Sponsorship of $850 per yearNew Silver Sponsorship of $600 per yearNew Bronze Sponsorship of $350 per yearYour Name*
Title/Position*Business Name*Business Categories*Please check which categories are appropriate for your business
Building & Construction
Business & Professional Services
Car & Boat
Education & Training
Finance & Insurance
Food & Beverage
Hair & Beauty
Information & Communication Technology
Manufacturing and Industrial
Medical, Health & Therapies
Mining and Agriculture
Organisations & Government
Sports & Fitness
Tourism & Recreation
Wholesale and Distribution
Briefly describe what products and services your business provides*Business Street Address*A Google Map will be provided on the SBC Member Directory based on this address.
Address Line 2
State / Province / Region
ZIP / Postal Code
AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe
Work Phone*Work FaxMobileMobile PrivacyMake PublicSBC Use OnlyEmail for SBC Communications*
What is the size of your organisation?*SBC may use this information to publish aggregate statistics about usage, membership, traffic patterns and other related site information that does not personally identify members. At no time will any individuals or businesses be specifically identified in anyway and individual information will be kept confidential within SBC Committee Administration.0-5 People6-20 People20+ PeopleI'd rather not sayWhat is the approximate annual turnover of your organisation?*SBC may use this information to publish aggregate statistics about usage, membership, traffic patterns and other related site information that does not personally identify members. At no time will any individuals or businesses be specifically identified in anyway and individual information will be kept confidential within SBC Committee Administration.Less than $1M$1M to $5M$5M to $15M$15MI'd rather not sayHow did you hear about SBC?
Referral from a colleague/friend (please specify below)
Saw/Received a flyer
Other Websites (Please specify below)
Referred by the City of Marion
Referred by the City of Mitcham
Other (Please specify below)
Referred by (if applicable)Is there anyone you can suggest that may be interested in joining SBC?Please include their name, business name and email or phone number. Thank you!Photography Permission*An SBC representative will on occasion be taking photos
of guests for use in ongoing promotion of the
Organisation, its members and its services. If you do not wish
your photograph to be reproduced please select so here.
I AGREE to allow my photo to be taken and publishedI DO NOT AGRE to allow my photo to be taken an publishedWhat would you find the most valuable about your membership?*
Networking / Information
Seminars / General
Meetings / Bulletin / Community
Other (Please use comments field below)
Are there any further comments you would like to add?
Optional SBC Directory InformationThe following information will be used to provide your business with the best possible listing on the SBC website and in our newsletters.
By providing these details/files you authorise SBC to publish this information in any online or offline activities directly related to the association - eg. SBC Member Directory, SBC Weekly Bulletin, SBC Facebook Page etc.
All fields are optional and can be updated in the future by resubmitting this form or emailing the Business Facilitator, at email@example.com
If you do not wish to submit any of this additional information, simply scroll to the bottom of this page and click the SUBMIT button.Email for Directory ListingUse this field to specify the email address you would like published on the SBC Member Directory - if not provided we will default this to the email we send your SBC Bulletin to.
Logo (Best size is 225 x 150px)Your Business Logo will be presented as best as possible within the formatting limitations of our website. The logo will also be hyperlinked to your Business Website.Accepted file types: jpg, gif, png.Profile Picture of You (Best size is 225 x 150px)This picture will appear in the Bio section of your SBC Directory listing and may also be used in our Newsletter.Accepted file types: jpg, gif, png.Company InfoGive us a 1-2 paragraph overview of your company services and products. You can also include one link to a YouTube video that will be embedded on your SBC Directory listing.BioThis section is for a 1-2 paragraph professional Bio - tell us about your skills, background, your history with your company etcSocial MediaProvide the URLs for your business/professional Social Media Pages.Facebook
Other Social MediaIf you have other Social Media links that you would like included please list them here. If possible they will be added to your SBC Directory listing.
To Join SBC Today
Simply click on the 'Join SBC' tab above and fill in the form
For futher information contact:
Business Association Facilitator
Association Postal Address:
PO Box 292
Edwardstown SA 5039