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When it comes to Texas, just say ?.~~.'
•:~ "`~: '. " to the success of our rural
communities. "~c-~"' to bringing dollars
«ti. ,,,
and jobs to our small towns. 4 4:
to everything that bolsters what made
our state great to begin with: the growth
and prosperity of every town, city and
county, regardless of size.
Joining Texas Yes! is easy. There is no cost and the application is simple. Texas Yes! Community
Membership is open to cities, towns, counties and governmental entities located in rural Texas. Communities eligi-
ble to apply for Texas Yes! must be located in anon-metropolitan area, or an unincorporated area, or a city with a
population under 20,000 that does not adjoin a city or group of cities with an aggregate population of 50,000 or
more. A map of metropolitan areas (as defined by the U.S. Census) can be found online at www.TexasYes.org or
received via fax or mail by calling (866) 4TEX-YES.
Everyone's support matters) That's why a special Texas Yesl Business Membership is open to businesses,
including chambers of commerce, councils of government, economic development corporations, sole proprietors,
partnerships, cooperative organizations or corporations. Business members' principal place of business must be in
Texas and they must have a business location in rural Texas. A limited Associate Membership is also available to indi-
viduals, organizations and associations that wish to support rural communities and businesses. All that's required is
a commitment to supporting and promoting the many facets of rural Texas -whether you're a Texas publication,
travel association or other entity working to ensure that Small Town, Texas gets all the attention it deserves.
TEXAS YES! MEMBERSHIP APPLICATION
Members will be able to reap an array of benefits,
including:
• Use of the Texas Yesl logo on promotional materi-
als to indicate participation in the Texas Yesl cam-
paign promoting rural Texas and to take advantage
of the visibility of the program;
• The Texas Yesl newsletter packed with information
and news of interest and use to rural communities;
• Regular a-mail updates with timely information on
workshops, resources and agencies focused on rural
development;
• Inclusion in the Texas Yesl database available online
to highlight rural Texas communities and their
efforts; and
• Involvement in new Texas Yesl marketing opportu-
nities being added all the time.
IF A COMMUNITY, COMPLETE FIELD 2.
IF NOT A COMMUNITY, MOVE TO FIELD 3.
2. COMMUNITY DETAIL
Population: ~ ~ (a7S Q
3. APPLICANT INFORMATION
Full legal business name
(owners name if sole proprietor - no aliases)
~' 1PX'l'~ ~-©lt(l~~
D.B.A. (if applicable) T
It is required that at least one type of identification num-
ber be provided. Comptroller Taxpayer ID is preferred
for all but sole proprietorships.
1. APPLICANT TYPE
f~Community Member (specify type)
^ City ^ Town [~ County
^ Governmental Entity
^ Business Member (specify type)
^ Chamber of Commerce
^ Economic Development Corporation
^ Council of Government
^ Sole Proprietor ^ Partnership
^ Cooperative Organization ^ Corporation
Comptroller Taxpayer ID No.
Is this a temporary ID? ^ Yes ~ No
Federal Taxpayer ID No. ~ y _ ~ ~ I ~ q ~
Social Security No. (sole proprietors only)
Don't forget to sign the back of the application)
^ Associate Member (specify type)
^ Individual ^ Organization ^ Association
4. RESPONSIBLE OFFICIAL, OFFICER,
PARTNER, MANAGER OR OWNER
Please list the full legal name (no aliases or nicknames)
of the primary person responsible for the applying entity.
For acity/town county/ governmental entity: the mayor,
county judge or other applicable official; for a civic
organization, chamber of commerce, community develop-
ment corporation or economic development corporation:
the executive director; for a limited liability company:
the president or CEO; for a limited or general partner-
ship: the managing partner or general manager; for a
sole proprietorship: the owner; for any other type of
business: the general manager.
^ Mr. ^ Mrs. ^ Ms. ®Other J
~~-}- 7 i to ~ >/
First name M. h Last name
(~,3p) `~'1,J'v~~ II Ext. ~~Lrc9 Ln ~,,-~.~t5
Phone E-mail
Kerr~;-le ~ -z8oa6
City State Zip
County
5. PERSON TO CONTACT FOR TEXAS YES!-
RELATED MATTERS
^ Mr. ^ Mrs. ^ Ms. ^ Other
7. PHYSICAL ADDRESS
Address No P.O. Box
City
State Zip
County
8. DESCRIPTION OF PRODUCTS/SERVICES -
REQUIRED
In 50 words or less, provide a brief description of the
applying entity (Tell us about your community, your
business or your organization. Who are you? What do
you do? What makes you unique?).
name M. L Last name
Title
- Ext. ( ) -
Primary phone Secondary phone
(optional)
( ) - Ext.
Fax (optional)
6. CONTACT MAILING ADDRESS
City State Zip
County
Web site address.'
TDA M585 05/04
9. CONTRIBUTION TO THE GOAL OF
TEXAS YES!
In 100 words or less, tell us about your commitment
to rural Texas. Provide examples of your current or
future projects to stimulate the rural economy, attract
businesses to rural Texas or grow rural tourism. An
important part of Texas Yesl is sharing success stories.
So tell us yoursl Examples could detail how your com-
munity/business/organization pledges to develop and
implement a local project for:
^ Community improvement ^ Tourism
^ Revitalization ^ Beautification
^ Leadership training/mentoring ^ Other
^ Creating economic value for the greater good
of the community (e.g., job creation)
SIGNATURE (Application MUST Be Signed)
The applicant shall comply with all applicable
laws and regulations.
The applicant, by and through their personal or
agent's signature below (1) certifies that all information
provided in connection with this application at any time is
true and correct to the best of the applicant's knowledge;
(2~ acknowledges that any misrepresentation or false state-
ment made by the applicant, or an authorized agent of the
applicant, in connection with this application, whether
intentional or not, will constitute grounds for denial,
revocation, or non-renewal of any license issued pursuant
to this application and/or assessment of monetary adminis-
trative penalties; and (3) if applying as an individual,
further acknowledges that this application may be denied
and that any license issued pursuant to this application
may be suspended, revoked, or denied renewal due to
delinquency in payment of a guaranteed student loan and
that any license issued pursuant to this application may
be suspended or denied renewal for failure to pay child
support. If signed by an agent (including employee) of
the applicant, the person signing certifies that he or she
is authorized to make the preceding certifications on
behalf of theypplicant,
name
~-a,..~~ Q~-
Title
Applicant Signature
DateDate ~ ~ l Z7 / ~~
month day year
r
TexasYes~
Texas Department of Agdcultu~e
Susan Combs, Commissioner
For Additional Information:
Call Toll Free 866.4TEX.YES or www.texasyes.org
P.O. Box 12847 Austin. TX 78711 Phone 512.463.7476 Fax 512.463.1104
For the hearing impaired: Voice 800.735.2988 TDD 800.735.2989
www.agr.state.tx.us