Participation application

Company Name:
Contact/President:
Address:
Phone:
City:
State:
Zip:
Fax:
Email:
Website:
Years In Business:
County Specialty License #:
Occupational Licenses:
Specialties Listed:
Recommended By:
Relationship:
Phone Number:
Business Recommendation (Required)
Name:
Company:
Position:
Phone:
Fax:
Email:
Condo Association Recommendation (Required)
Name:
Company:
Position:
Phone:
Fax:
Email:
Personal Recommendation (Required)
Name:
Company:
Position:
Phone:
Fax:
Email:
Condo association experience, names of condos and contacts (1000 characters maximum):
Category:  SELECT AccountingapprasalsBanking - All ServicesBuild matlBusiness Banking ServicesCabinetryCarpetCarpet cleanerCleaning & JanitorialComputer servicesConcrete patchingConcrete restorationCondo assoc MgmtCpaDoorsDriveway coatingDriveway strippingFinanceFlooringGeneratorsHandrailsInsuranceinterior decoratingInvestment ServicesLawn & LandscapingLegalMold & mildew CleanMortgage And Home LoansMoversPersonal Banking ServicesPest ControlPoolPool servicePressure WashPrinting&mailingProperty mgmtReal EstateRelocation specialistsRentalsReserve StudiesRipout & trash removalRoofing RepairsScreeningSecurityShutter MaintsurveyorTileTile-grout cleaningtitle companyUnit ManagementWall Paper & coveringWater And Fire DamageWaterproofingWindows
Preferred Areas of Service:  SELECT North BrevardCentral BrevardSouth BrevardBeachesAll of Brevard
Brief Description of Products and Services (1000 characters maximum):
Picture
By signing this application, I understand that by providing the above accurate information, I will be reviewed for participation as a Competent Licensed Specialist, Dedicated to the "Condo Prioritysm" Program. I also consent to receive telephone, email, fax and written communication sent by or on behalf of Custom Business Specialists, Inc. and its associates for confirmation and review. Please email garyKitchens@cfl.rr.com site coordinator, or fax 321-784-9343.
Authorized Signature:
Title:
Date:
Verification: enter the images you see into the textbox below.

Our site Marketing Awareness Program includes: your own full page and link, www.BrevardCounty.com Home Page feature article, Annual SCCA Trade shows, Monthly SCCA Meeting Promotions, SCCA Directory, Rotating Banner at Cobb 16 multiplex theater, Beach Valu Directory Cover listing, reverse links, emergency 811 News Releases for the existing and future associations and residence and more...