PBPA Membership Application – Pay by Check

Your Business & Contact Information

After completing this form you will be redirected to a PBPA website page with payment instructions.

* asterisked fields are required.

Additional Email Addresses, separated by commas, to subscribe to the PBPA Email Notificaton list.
Business Name as you would like it listed on the PBPA website
Enter only your 5-digit zipcode
The days and hours that your business is open or a general statement, e.g., By Appointment
Please enter a summary marketing description of your business to be displayed on the PBPA website
The membership year runs from September 1 through August 31.