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Membership Application

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

General Membership $75.00
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 $175.00
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
 

WELCOME TO THE PENFIELD BUSINESS ASSOCIATION!

We are processing your application request. 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 of the benefits of membership. If you have any questions, please call the PBA 585-234-9706.

THANK YOU!

Please mail all payments and correspondence to:

Penfield Business Association 
P.O. Box 268
Penfield, NY 14526

 Membership Form

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