CitizensMatch Application

Business Name
Business Type
Address
City	State	Zip
Contact	Position
Tel. No.	Fax No.
Email	Website
Individuals and business owners can purchase any of my products/services in exchange for Citizen Dollars
I will only offer specific products/services in exchange for Citizen Dollars
I am willing to commit to selling a minimum of C$1,000 worth of my goods and services in the first year of my membership in order to qualify for a $C500 credit upon joining.
Are there particular businesses where you would like to spend the Citizen Dollars that you earn? Please list them along with contacts there if you are willing to act as a reference and our Broker will contact them.

I hereby declare that I am applying to CitizensMatch for the privilege of trading goods and services with other members. I understand and agree to pay transaction fees (currently 7.5% in C$) on the gross value of all purchases and sales made through CitizensMatch. I agree to repay all Citizen Dollars requested according to the Trading Rules and Regulations of CitizensMatch, and that any goods or services used as security for Trade Loan requests will be available for sale within the CitizensMatch system at any time. Please type your initials here to indicate agreeement with the above