BNI Member Lost or Replacement Badge Request

BNI MEMBER REPLACEMENT BADGE REQUEST

BNI Atlanta - Member Resources Tools
Use this form for:
- Lost or Replacement Badge
- Member Name Change
- Company Name Change
All Badge Requests are created on a as needed basis by BNI Atlanta. They are created and shipped once a month. Please do not request a badge if you are a NEW Member. All New Members Badges are automatically created and shipped.

If you have any questions, please contact the BNI Atlanta Regional Office at info@bniatl.com or 678.264.8708.
Reason for New Badge*

Lost BadgeClassification Change
Name on the Badge*

First NameLast Name
Company Name*
How you want it displayed on your new badge
BNI Classification / Industry*
Type of Badge*
Sponsor Recognition*

I do not have 6 Sponsorships yetGold Member (6 Sponsorships)Double Gold Club (7-11 Sponsorships)Triple Gold Club (12-17 Sponsorships)Platinum Club (18-23 Sponsorships)Double Platinum (24-29 Sponsorships)Triple Platinum Club (30-35 Sponsorships)Diamond Club (36-41 Sponsorships)Double Diamond (42-47 Sponsorships)Triple Diamond (48-53 Sponsorships)Double Elite (60-65 Sponsorships)
BNI Chapter Name*
What YEAR did you begin BNI?*
Type in a year (e.g. 2019)
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Member Badge Purchase*

BNI Atlanta Replacement Name Badge$12

BNI Atlanta Member Replacement Badge

Quantity
Item subtotal:$0.00

Total $0.00

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

Country

BNI MEMBER REPLACEMENT BADGE REQUEST