PBPA Membership Application – Pay Online

Your Contact & Business Information

After submitting this form, you will be directed to PayPal for payment processing. When your transaction is complete, you will receive an email confirmation from PayPal and you will be redirected back to the PBPA website. Within a few weeks you will receive a Welcome packet from PBPA in the mail.

* 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.