RBA Membership Application

• Online membership application is below or if you prefer, print the application and mail or fax the form
  to 845-735-2482.
  
• Questions, please call 845-735-2100 or email Roger Scheiber at rscheiber@rocklandbusiness.org.
  

Fees and Payment Options

• Membership dues based on the number of employees.
• Dues are payable by check or credit card:
  • Checks: Make payable to Rockland Business Association and mail to:
    One Blue Hill Plaza, P.O. Box 1567, Lobby Level, Pearl River, NY 10965
  • Credit Cards: For your security, do not email credit card account information to the RBA. An RBA staff member will contact you directly for this information.
• There is a $25 one-time processing fee in addition to the dues.

RBA Membership Online Application Upon form submission, a Rockland Business Association staff member will contact you to verify your application and complete any additional information. *(denotes required field) First Name: * Last Name: * E-Mail Address: * E-Mail Address again: * Please enter your E-mail Address a second time. Company Name: * Address: * City, State and Zip: * Phone: * Fax: Website Address: Type of Business: Annual Dues / # of Employees (except Non-Profit Charities): Select One 0-5 employees $370 annual dues 6-10 employees $445 annual dues 11-25 employees $625 annual dues 26-50 employees $840 annual dues 51-100 employees $1135 annual dues 101-150 employees $1440 annual dues 151-200 employees $1935 annual dues 201-300 employees $2180 annual dues 301-999 employees $2445 annual dues 1000 plus employees $2920 annual dues Annual Dues Non-Profit Charities / # of Employees: Select One 0-25 employees $310 annual dues 26-100 employees $520 annual dues 101 plus employees $1050 annual dues Form of Payment: Credit Card Check Company Contacts The contacts below will receive direct communications from us on events, news, etc Firm Representative & Title (Contact to be listed as RBA Member): * Email: * Office Manager: Email: Purchasing Contact: Email: Technology Contact: Email: Human Resources Contact: Email: Marketing Contact: Email: Other contact: Email: Sponsored by: Why did you join the RBA? Security CAPTCHA Code * Powered by Fast Secure Contact Form - PHP

"We have realized powerful relationships and long term friendships. The RBA and the management staff truly help foster growth for all its' member companies and the RBA proves to be a worthwhile organization year in and year out." Stephen Hoey KDF Reprographics, Inc.   "For a construction services company, the pre lunch networking hour has generated a variety of new leads, both active and potential for Verticon. I have learned over the years that active participation pays and I certainly am the beneficiary of all the networking opportunities that have been afforded us. Irving Zuckerman Verticon   "Woman's Forum meetings are uplifting! You have done a fabulous job in making the monthly meeting interesting and packed full of value and inspiration " Ann Zeilingold First Meridian Mortgage