MPMA New Member Registration

Join the MPMA

Please fill out this form and pay your Membership Dues to join the MPMA.
Business Name*
Business Owner*

First NameLast Name
Business Owner's Direct E-mail*
Business Owner's Direct Phone Number*
Business Phone Number
Please enter a valid phone number.
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Magnolia Park Boundaries:

The Magnolia Park District encompasses West Magnolia Blvd. between Clybourn and Victory, and Hollywood Way between Clark and Chandler.

Businesses outside of Magnolia Park may still join MPMA as Affiliate Members. Benefits for Affiliate Members are listed on our website.
Is business within the Magnolia Park District?*

YesNo - I am an Affiliate Member
Website
Social Media *
Type of Business*
Business Images

New members are highlighted on the MPMA social media accounts and website. Please include the images you would like used to represent your business. If you do not provide an image, we will choose one from your website or social media account. If you have trouble uploading an image to the form, you can also email it to: membershipmagparkburbank@gmail.com
Logo & Store Images (4 max)

Cancelof
If you do not provide an image, we will choose one from your website or social media account.*

I understand and agree
Newsletter Subscriptions

The MPMA newsletter is the best way to stay informed of the latest news and announcement that affect Magnolia Park merchants. You'll automatically be signed up for the newsletter with your Membership Registration. Be sure let us know if you don't start receiving MPMA emails.
Submit Date*

MonthDayYear
Membership Dues & Renewal

Membership renews automatically each year unless canceled. If you are paying by check, your registration is not complete until payment has been received. **All payments are non-refundable
Are you paying by Check?

YesNo
Pay by Check Instructions:

Please write your check to MAGNOLIA PARK MERCHANTS ASSOCIATION and mail it or drop it off during business hours at Blast From the Past at 3117 W. Magnolia Blvd., Burbank, CA 91505. Your Membership Registration is not complete until payment has been received.
Annual Membership Dues*
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MPMA Membership Annual Paypal Subscription$150 Membership + $5 Processing Fee = $155/year. Membership renews automatically each year unless canceled. You will receive a renewal email 30-days before auto renewal. To cancel, or for questions, email: magparkmembership@gmail.com
$155.00 for each year

Total

$0.00
Questions, Comments, or Additional Info
Should be Empty:

Join the MPMA

Magnolia Park Boundaries:

Business Images

Newsletter Subscriptions

Membership Dues & Renewal

Pay by Check Instructions: