Joining TIBA

Membership Criteria:

Business must be privately owned.
The stock of the company, if incorporated, cannot be publicly traded.
The business entity is the actual member.
The benefits and services are then available to all owners, employees and family members of that business.
Business must operate at least 30 hours per week to qualify for health and dental benefits.
Non-profit agencies, self-employed and home based businesses are eligible.

Fill out the form below to join TIBA.

Please note that you will be required to pay your annual dues upon completion of this form. Your listing in the members directory will not be active until your dues are paid. If you would prefer to pay by check, click "download application," and mail the application with your check to the address shown, or fax registration form to 785-233-7802

Username: *

Password: *

Email: *

First Name: *

Last Name: *

Company: *

Work Phone: *

# Employees: *

Address: *

City: *

State: *

Zip: *

Billing Address: *

Billing City: *

Billing State: *

Billing Zip: *

Fax:

Web Site:

Business Type:

Who referred you to TIBA?

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