IBBA Mid-America Affiliates

Our affiliate members are advisors and experts who align with the chapter’s professional principles to provide a foundation of quality, responsibility, integrity, and honor in all business relationships and transactions.

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Date
Name*
First Last
Title*
Company Name*
Primary Business Function of Company*
Company Address*
Street Address Address Line 2 City State ZIP Code
Home Address
Street Address Address Line 2 City State ZIP Code
Username*
Password*
Enter Password Confirm Password
Email*
Enter Email Confirm Email
Please upload your photo*
Accepted file types: jpg, jpeg, png, Max. file size: 50 MB.
Photo should be a good quality color photo of you. Allowed extensions are: jpg, jpeg and png.
Please upload your logo*
Accepted file types: ai, eps, pdf, jpg, jpeg, png, Max. file size: 50 MB.
Logo should be a good quality image. Allowed extensions are: ai, eps, pdf, jpg, jpeg and png.
Office Phone*
FAX Number
Home Phone
Cell Phone*
Website
Facebook

What is your company's FaceBook link?
Twitter

What is your company's Twitter handle?
LinkedIn

What is your professional LinkedIn account?
Please describe how you or your company works with business brokers.*
State licenses and/or Professional Accreditations you hold:
Please describe your company and/or personal areas of specialization:*
Please list memberships in other Professional Associations:
Are you currently a member of the M&A Source?*
How did you hear about the IBBA Mid-America?*
Invited / Referred by*
Other*
Comments
Check here if you would like to be contacted about sponsoring a IBBA Mid-America event/conference.
Check here if you would like to be contacted about joining a IBBA Mid-America committee.
Agreement*
I Agree

1. I have received, read and, if approved for membership, agree to abide by the Code of Professional Responsibility of the Mid-America Business Broker Association and all future amendments thereto.
2. I authorize the membership committee to verify the information herein.
Affiliate Membership*
Price:
Payment Method*

American Express
Discover
MasterCard
Visa
Maestro
Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro
Card Number Expiration Date Security Code Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

Affiliate Member Application

IBBA Mid-America Affiliates