Membership Checkout Membership Information You have selected the Chapter Leaders Support membership level. The price for membership is $0.00 now. Account Information Username Password Show Password Confirm Password Email Address Confirm Email Address Full Name LEAVE THIS BLANK Already have an account? Log in here Basic Information Name Phone Email Full Address DOB How did you hear about RSRWBA? Referral Name/Code Business Details Business Name Business Website Business Industry/Category Years in Business Describe your business or what you offer. Business Type Non-profit Association Retail Storefront Physical Office Homebase Online None Do you have any of these certifications? None Minority Business Enterprise (MBE) Women Business Enterprise (WBE) Disadvantaged Business Enterprise (DBE) Small Business Enterprise (SBE) Woman-Owned Small Business (WOSB) Economically Disadvantaged Woman-Owned Small Business (EDWOSB) Veteran-Owned Small Business (VOSB) Service-Disabled Veteran-Owned Small Business (SDVOSB) 8(a) Business Development Program (SBA 8a) HUBZone Certified Business Local City or State Certification (for example, NYC M/WBE, NJ M/WBE, SC M/WBE) National Minority Supplier Development Council (NMSDC) Certified Women’s Business Enterprise National Council (WBENC) Certified Chamber of Commerce or Industry Partner Certification Other (please specify) Answered Other? List below Your Bio (copy/paste link) List your social media accounts (up to 3) Additional Business Info. Upload Your Business Logo or Headshot Goals, Motivation & Engagement What motivated you to join RSRWBA? What are your top 3 business or personal goals for this year? How do you prefer to engage with the community? Events Forums Online Courses Mentorship Leadership All Would you like to be paired with a mentor or accountability partner? Yes No Leadership Only T-shirt Size Agreement & Consent I agree to uphold the mission and values of Real Sisters Rising Women Business Association. Yes NO I understand that membership fees are non-refundable and renew monthly/annually. Yes NO I consent to be featured in RSRWBA marketing, photos, or media (optional). Yes NO Do you give us permission to send you exclusive updates, event invitations, and RSRWBA news? Yes NO Signature Initials for your digital signature Billing Address First Name Last Name Address 1 Address 2 City State Postal Code Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong S.A.R., China Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Virgin Islands US Armed Forces Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Phone Processing...
