Penfield Business Association

Membership Application
Name of Member:
Name of Business:
Business Address:
Business Phone:
Business Fax:
Email Adress:
Website Address:

Membership Renewal $ 85.00/$ 185.00

If renewing your membership, please complete the information above and check the membership type below.

General Membership $85.00

This membership includes one postal mailing address for receiving PBA mailings and up to five individual e-mail addresses. This membership will have one vote. Please enter additional member names and email addresses (separated by a comma) on the right.

Member 1:
Member 2:
Member 3:
Member 4:

Premium Membership $185.00

This membership includes multiple individuals receiving PBA mailings at their individual postal addresses and up to ten individual e-mail addresses. This membership will have one vote. Please enter additional member names and email addresses (separated by a comma) on the right.

Member 1:
Member 2:
Member 3:
Member 4:
Member 5:
Member 6:
Member 7:
Member 8:
Member 9:

What topics would you like to hear about at future meetings?
Would you be interested in writing an article for the newsletter/web site?	Yes No
Would you be interested in serving on any of the following committees?
Membership Government Community Events Newsletter	Annual Business Directory Public Relations & Advertising Penfield in Bloom(gardens) Programs
PAYMENT OPTIONS To pay by check, please mail your membership dues as soon as possible to Penfield Business Association, P.O. Box 268, Penfield NY 14526. Once we have received your payment, we will send you a membership card entitling you to all the benefits of membership. If you have any questions, please call the PBA (585) 348-8360. Please click on the "Send Contact Form" to submit you're electronic membership form.
To pay by either Credit Card or Bank Debit Card, please click on the "Pay by Credit Card" link below and you will be taken to our PayPal payment center. You'll be charged $88.00/$191.00 depending on you membership type plus credit card fee's. Once we have received your payment, we will send you a membership card entitling you to all of the benefits of membership. If you have any questions, please call the PBA (585) 348-8360.

Membership Application

PAYMENT OPTIONS

THANK YOU!