Membership Fee:

$109.99 Monthly
$1090.00 Annual (receive 2 months free)
One-time Set Up Fee: $5.00

Membership Benefits

As an Evolving Entrepreneur Member, you will receive:

25% off Creative Space additional hours
50% Access to BLAQUE events
15% off Vending at all BLAQUE events
Unlimited Access to BLAQUE Lounge during Business Hrs.
1 Day per month of Shared Office Use
3 Daily Guest Passes/MO
6 hrs Creative Space/MO
- Podcast
- Meeting
- Training

Applicant Information

Legal Name

First Name
Last Name

Address

Street Address

City

State

Country

Postal code

Personal Phone Number

Please enter a valid phone number.

Personal Email

[email protected]

Upload a copy of your government issued photo ID

Professional Information

Do you hold any professional license(s) *

Yes

No

Type of professional license held

Professional license number(s)

Upload a copy of any professional license(s) you hold

Business Information

Do you have a registered business? *

Yes

No

if yes, What is the business name ?

If you have a business, What is the registered business address?

Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code

Date Business was formed

Business Phone Number

If you do not have a business phone number, please enter your personal number.

Business Email

If you do not have a business email, please enter your personal email.

Do you have a logo?

Yes

No

Upload your logo

Membership Selection

Desired Start Date

Membership Options

Monthly – $109.99/month

Annual – $1090.00/year (2 months free)

By checking this box I agree to the terms and conditions outlined below

Payment Information

Credit Card

First Name
Last Name
Credit Card Number
Security Code
Expiration Month
Expiration Year

Billing Address

Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code

Terms & Conditions

Membership fees are billed monthly or annually as selected.
The one-time $5.00 set-up fee is due upon application.
Creative space usage beyond the included hours is subject to the member discount rate.
Guest passes and shared office use are non-transferable and must be scheduled in advance.
Membership is subject to BLAQUE Executive Suites’ Terms & Conditions and House Rules.

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Signatures

Clear

Date Signed