Membership Form for OSBA (614) 759-6355

This form will allow you to register, and become a member the Ohio Small Business Association. Please print out this form and fill out the information below and mail it to us. Make your check payable to: 

OSBA
6543 E. Main St., Suite A1, Reynoldsburg, OH 43068
Attach it to the bottom of this form before mailing it to us.

First Name: ______________________  Last Name: ___________________________

Company: _______________________

Address (City, State, Zip) _________________________________________________

Phone: Day: __________________   Evening: _______________  FAX: ____________

Email: ________________________________________________

Sic Code: _____________  Number of Employees: ____________

Type of Business: ___ Sole Proprietor  ___ Partnership ___ LLC  ___ Sub-Chapter S Corporation 

___ 501 (C) (3) Corporation (Non-profit Corp.)  ___ Corporation  ___

Other: _____________________________

What does your business do?

 ______________________________________________________________________________

How did you find out about OSBA? __________________________________________________