The Christian Buying Network
295 East Deering Road
Deering, NH 03244
tel. (603) 552-2006
fax. (877) 839-2163

JOIN THE NETWORK

To join, please fill out the application below. If you'd like more information before signing up, fill out our information request form and your local network representative will contact you.

All fields with an asterisk (*) must be filled out.

Company Information

* Organization Name:

Organization DBA:

* Is this a non-profit organization?

* Season of Operation:: Please specify:

* Phone Number:

Fax Number:

Physical (Shipping) Address

* Address:

* City:

* State:

* Zip Code:

Alternate Physical (Shipping) Address:

Address:

City:

State:

Zip Code:

Mailing (Billing) Address

: Check to use Shipping Address:

Address:

City:

State:

Zip Code:

Primary Contact Information

* First Name:

* Last Name:

* Job Title:

* Phone Number:

* Email:

Secondary Contact Information

First Name:

Last Name:

Job Title:

Phone Number:

Email:

Estimated Annual Expenses

Food:: Please specify:

Office Supplies:: Please specify:

Propane:: Please specify:

Electric

Natural Gas

Payroll Services:: Please specify:

Credit Card Processing:

Building/Renovation Costs:

Waste Removal:

Other Expenses:

Additional Information

Notes/Instructions:

Agreement Terms and Submission

Membership Agreement and Participation Statement

: * I agree to the terms of the Membership Agreement and Participation Statement

* Network Representative:

* Select a Network:

* How did you hear about us?