POWERNET NEW MEMBER APPLICATION

(Click on the printer icon or pdf icon to fill application out)

Think you have a friend who would be interested in PowerNet? Then just click on the envelope icon and send this link to them.

Interested in joining PowerNet? You can mail your application to

Techdesigno
533 Northfield Avenue
West Orange, NJ 07052

or email it as a word doc or pdf to This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Please provide the following information so we may get to know you better and ascertain whether POWERNET membership is right for you.

Your Name: _____________________________________________________________

Your Business Name: _____________________________________________________

Business Address: ________________________________________________________

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Business Telephone Number: _______________ Fax Number: _____________________

Email Address: __________________________ Website: _________________________

Year Established: ___________  Years at Present Location: ________

Briefly describe the products or services you provide:

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Who recommended you to POWERNET: _______________________________________________

Have you ever belonged to a networking group before? _______

If yes, which one(s): _______________________________________________________

What do you hope to gain from POWERNET?

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What do you feel you can bring to POWERNET as a new member?

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What do you hope to gain from POWERNET?

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Is there anything else you would like to tell us about yourself and/or your business?

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