Application for Membership

             ...an alliance of entrepreneurs who do business holistically,

          recognizing the unity of all life and the interdependence of its parts.

                To join - print and mail application to address below

By this application, I request membership in the Holistic Entrepreneurs Alliance

and entitlement to all benefits of membership. I operate my business in a holistic

manner using a win/win approach that serves the good of all while opening to

abundance.

Name ________________________________________________________________________

Home Address ________________________________________________________________

______________________________________________________________________________

Phone (Home) ________________________  Phone (Mobile)  _______________________

Phone (Business) _________________________

Email _______________________________ Website _________________________________

Business Name  _______________________________________________________________

Business Address  _____________________________________________________________

_______________________________________________________________________________

Business Description ___________________________________________________________

 ______________________________________________________________________________

Annual Membership Fee: $85.00 ~ Additional family member $45.00

Mail Check to:  Holistic Entrepreneurs Alliance,

c/o Dianne Adams, 501 Slaters Lane #422, Alexandria, VA 22314  

Signature ________________________________________ Date _______________________