Application information:
First name:
Last name:
Email address:
Company: Website:
Mailing address: Business Type (Direct Sales, Service) / Description of Business:
Benefits of Membership:
I hope to offer the group: As a part of the group, I hope to achieve:
Best way to contact you:	Email address Mailing address
Once my application is approved, I understand and agree that as a member of WE of VA, I agree to a commitment of participation. I understand that I am required to attend at least two meetings per quarter, and that I cannot miss more than two meetings in a row without the consent of the group.    I agree to the payment of nominal dues in the amount of $10.00 per calendar year. By providing my digital signature below, I agree to these terms and agree to fulfill these attendance requirements. Digital Signature: Date: