Women TIES :: Women Inspiring Entrepreneurial Success

Application Form

Enhanced Membership

We look forward to promoting your company through the enhanced membership benefits which give your company substantial promotion in our growing directory of women entrepreneurs. To become an Enhanced member of Women TIES, please:

Complete the form below.
When you come to the "region" section, please choose the region where your office is headquartered and (optionally) another prime business region for your company.
Submit the form for approval. Please note: approval may take up to 3 business days.

Once you receive notification of approval, you will need to use the user name and password you set up in the form below to log into the Member Area of the site and pay for your membership through PayPal. Once payment has been made, your Enhanced benefits will begin immediately.

In the Member Area, you can update your member profile during the year. We encourage you to maintain accurate and up-to-date information about your company so potential clients can contact you. You can also upgrade your membership at any time to gain even more visibility and sales opportunities for your company.

NOTE: Women TIES, LLC, membership payments are non-refundable during the 365-day membership period.

First Name *

Middle Initial

Last Name *

Title *

Company *

Ownership *

Address 1 *

Address 2

City *

State *

ZIP *

Region 1 *

Region 2

Phone 1

(enter in xxx-xxx-xxxx format)

Phone 2

(enter in xxx-xxx-xxxx format)

Fax

(enter in xxx-xxx-xxxx format)

Email 1 *

Email 2

URL 1

(enter full URL beginning with "http://")

URL 2

(enter full URL beginning with "http://")

In Business Since (Year)

Number of Employees/Subcontractors

Multiple Locations?
(How many and where?)

Desired marketplace
(check all that apply)

Local
Regional
State
National
International

Business Category *

Business Category

Description (please limit to 50 words or less)

Speaker's Bureau Topics (please limit to 100 words or less)

Comments
(if none of the categories fits your business, if we've missed your region, if there's anything else you want to tell us, list your comments here)

User Name (10 character max.) *

Password (10 character max.) *

This helps us reduce spam:

* Required field

315.708.4288 | info@WomenTIES.com | P.O. Box 339 | Syracuse, NY 13211