Join the Wildwood Business Association

Please complete the form below. NOTE: Fields labled in bold are required.

Business Information
Business Name: (As it will be shown on the WBA website.)
Used by customers to find your products or services
Primary Business Category:
Secondary Business Category (If needed):
Tertiary Business Category (If needed):
Principle Owner First Name: Last Name:
Secondary Owner First Name: Last Name:
Business Address: Show Address on website: (checked-YES, unchecked-NO)
Business City: State: MO, ZipCode:
Map to Location:
                        (Copy and paste entire link from Google Maps, Bing or Yahoo maps into space above.)
Business Phone: (###-###-####)
Primary E-mail Address:
                                      (This address will be your account sign in e-mail address.)
Secondary E-mail Address:
Website Address:
(copy and paste actual address if possible. Important! Be sure your website address begins with http://)
Links to Social Media Sites (If your business has a Facebook Page, a Twitter account or Linkin account add those below.)
facebook-logo facebook:
(copy and paste actual address if possible. NOTE: Be sure address begins with http://)
twitter logo Twitter:
(copy and paste actual address if possible. NOTE: Be sure address begins with http://)
Linked in Linkedin:
(copy and paste actual address if possible. NOTE: Be sure address begins with http://)
Business Description (Enter a description of the products and/or services this business offers.)
Search Key Words:
(Enter additional words to those above that a person might use to find this type of business, its products or services.)
Type of Membership:
Member Account Password: (Six to ten alpha numeric characters. NO spaces.)
Security Code: captuca(Enter exactly as shown.)

Please review all information entered for accuracy and when satisfied, click once on the "Save Information" button.
After clicking on the "Save Information" button, your information will be stored in our database, our membership chairperson will be notified and you will be taken to a page where you can select and process payment for your membership.