Membership Application

Fill in information below to share the VISION and the BENEFITS of the South Meadows Marketplace Alliance.

Step 1: Select a Membership Level: (refer to the Membership Tiers Chart if needed )

PLATINUM – $3,250*

GOLD – $1,750*

BRONZE – $750*

Step 2: Complete the form below.		Step 3: Send check to: Alta Lash, UCAN, 20-28 Sargeant Street, Hartford, CT 06105 Application will be processed upon receipt of check. Make checks payable to SMMA. *NOTE: South Meadows Marketplace Alliance Annual Dues are categorized as a business expense and are therefore 100% tax deductible.
Business Name
Business Address
City
State
Contact Name
Business Phone
Cell Phone
Email
Date