YPN Membership Application Application can be used for renewal OR new membership. Application Type * Renewal New Membership Date of Application * Format: MM/dd/yy First Name * Last Name * Title/Position * Company * How long have you been at your current employer? * Business Address Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Email * Work Phone * T-Shirt Size (Unisex) * Membership Options * $175 for Individual YPN Membership for Chamber Members $450 Corporate Memberships (Three Memberships) $650 Annual Sponsor (Includes two Memberships and Promotional Opportunities) Membership is based on a 12-month period, September-August, and is pro-rated for those who join within the fiscal year. We want to get to know you better! How did you learn about YPN? Chamber Newsletter Chamber Email Chamber Website Local Media YPN Website Referral from: Other: What fundraising EVENTS are you interested in participating in? Dragon Boat Pancake Breakfast Dragon Boat Beer Tent What TOPICS are you interested in learning about? Bemidji Community Projects Educational Opportunities Leadership Development Professional Development Work-Life Balance Financial Planning Stress Management Community Healthcare Volunteer Opportunities Health & Wellness Marketing Conflict Management Entrepreneurship Generational Differences Problem Solving Other What industry do you belong to? Banking/Finance Engineering Entertainment Healthcare Higher Education Hospitality Insurance Media Nonprofit Marketing Real Estate Retail Other Do you have any dietary requests? Is your business interested in being a sponsor? Annual Sponsor Luncheon Sponsor Not at this time
