Community Based Organization Registration

Enter Your Update Code to Continue Where you Left Off

Note: Highlighted field = Appears on AWC website
   General Information
*Business Name:    
*Street Address 1: Street Address 2:
*Zip:    
*City: *State:
*Office Phone: *Company Website:
   Primary Contact
*Name: *Title:
*Email: Cell Phone:
   Secondary Contact
Name: Title:
Email: Cell Phone:
   *Membership Categories (select up to 3)
   About your Business
*Description of Business: * Note: This is limited to 2000 characters
  
*How did you hear about AWC?:
  
Company Logo Upload Logo(.png, .jpg, or .gif smaller than 500kb)
*Note: Reselection is needed if there are validation errors of any kind
No Logo Uploaded
Contact Profile Picture Upload Contact Profile Picture(.png, .jpg, or .gif smaller than 500kb)
*Note: Reselection is needed if there are validation errors of any kind
No Profile Picture Uploaded
  
   Payment Information
Total Due $350.00
CBO Annual Membership Fee $300.00
One-time Enrollment Fee $50.00

Payment Method


Please enter your credit card information below
*Credit Card Number(numbers only)

*Expiration Date(MM/YYYY)
 / 
*Security Code(number on back of card)

If you have issues with your payment, please email admin@awcmn.org



       | 




© 2022 UpNet Technologies - All Rights Reserved