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PENDLETON BUSINESS ASSOCIATIONMembership
Application
(Dues
Payable
January
1,
2007) $50.00
Annual
Membership
Fee Print
All
Information
Clearly Information
Provided
Will
Be
Utilized
for
Publications
and
PBA
E-Mails Business Name: _______________________________________________________________________Business
Address:
____________________________
City:
________________
Zip:
______________
Business
Phone:
_________________________
Business
Fax:
________________________________
Business
E-mail:
________________________
Web
Address:
________________________________ ADDITIONAL BROCHURE INFORMATIONHours of Operation: (Limit 50 Characters) ________________________________________________Business
Description:
(Limit
2
Lines
of
50
Characters
Each) ____________________________________________________________________________________ Do
you
have
a
Restroom
the
Public
can
use?
Yes
or
No Is
the
Restroom
Handicap
Accessible?
Yes
or
No ** All information provided above will be used to compile the PBA Shop Pendleton Brochure. Add
any
comments
below. EMERGENCY
INFORMATION
NEEDED Owners
Name,
Address,
E-mail
and
Emergency
Phone:_____________________________________ _____________________________________________________________________________________ Contact Person, Phone (if different than owner): __________________________________________Comments:
__________________________________________________________________________ _____________________________________________________________________________________ Make checks payable to Pendleton Business Association c/o JoAnn Karaffa-Owens, Treasurer, Pendleton Travel Company, 111 N. Pendleton Avenue, Pendleton, IN 46064, Phone 765-778-2141 |