2025-2026 PNBA Bookstore Membership Form

2025-2026 PNBA Bookstore Membership Form
Store Name*
Owner/Manager Name*

First NameLast Name
Store Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Store Phone:*

Area CodePhone Number
Member E-mail:*
Store Web Site:
Store type:

Prospective-location secured or to be secured this year.New onlyNew/UsedUsed onlyOnline onlyPop-UpMobile
Owners self identify as:

LGBTQ+ ownedIndigenous ownedLatinx ownedAAPI ownedWoman ownedBlack ownedPerson of color ownedVeteran ownedNeurodivergent ownedDisabled ownedNone of the aboveI choose not to answerOther
Our store:

Is an ABA memberIs an IndieCommerce storeReports sales to ABAUses BatchUses Bookshop.orgNone of the above
Store specialities:
Year store established:
POS system:
Number of Employees:
Average number of employees for single location
Sq. Ft. of book dept:
Please submit a store photo for the Member Bookstore page on our website. Show us what your location storefront looks like from the street or sidewalk, so we can help others find you! If no storefront is a available, then please send your logo.

Up to 10 MB.
Storefront photo (optional):

Browse Files
JPG or PNG Cancelof
Payment
Bookstore Membership
Would you like to request an optional 20% discount? (for Micro Stores only)

Yes please, our store is in need!No thanks, we've got it covered.
Total
Payment Total

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