Please Complete the Following Andreturn To

2018MEMBERSHIP APPLICATION/INVOICE

January 1, 2018 to December 31, 2018 (Due: January 31, 2018)

Please complete the following andreturn to:

Ontario BIA Association, c/o 280 Queen Street South, Mississauga, ON L5M 1M1

Tel: 1-866-807-2227 | | |

Name of BIA:
Contact Name: / Title:
Address:
Town/City:
Postal Code: / Municipality:
Telephone: / Email:
Website: / Twitter:
Facebook: / Instagram:

Help us advocate for you by providing us with the following information:

# of Staff employed in your BIA: / Part Time: / Full Time:
# of Businesses in your BIA: / Property Owners:
Estimated #of Employees in BIA Area: / 2017 # of New Businesses
Total Assessment Value of your BIA:
Total Levy of your BIA: / Total Budget:
Please attach a list of your current Chair and Councillor (and emails):
What year was your BIA formed:
Please provide estimates of the business makeup of your BIA
Food, Beverage, Pharmacy / % / Food services / % / Personal services / % / Professional Services / %
Retail / % / Other Services / % / Vacant / %
OBIAA communicates through Email – please confirm you wish to receive our Emails Y  N 
Please attach a list of who from your BIA and/or your Board would like to receive OBIAA’s emails.

Membership fee is based on your BIA Levy. Please remit the appropriate amount listed below:

BIA Levy Amount / Net Amount / HST / With HST
HST #873515167RT / Amount
Less than $150,000 / $ 216.49 / $ 28.14 / $244.63
$150,001 to $300,000 / $ 402.90 / $ 52.38 / $ 455.28
$300,001 to $500,000 / $ 568.61 / $ 73.92 / $ 642.53
$500,001 and over / $ 933.38 / $121.34 / $1054.72
Associate Membership(Ministry or Municipality) / $ 229.50 / $ 29.84 / $ 259.34
Supplier Membership / $ 408.00 / $ 53.04 / $ 461.04
*Ask about Group Memberships for Municipalities with 10 or more BIAs

Thank you for your support of OBIAA. We all benefit from a strong membership!

OBIAA Office Use Only
Name on Chq: / Date Rec’d:
Chq Amount: / Chq #: / Initials: