Membership Application Form for Association

Name

First NameLast Name

Phone Number

E-mail

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Which area(s) do you identify with the most

Social Media Page(s)

Website

Business Name

Business Industry

My Subscriptions*

Insider Access Insider Access (Free Tier)Price: $0 / foreverFor: Women who want to stay in the loop and take advantage of early access opportunitiesIncludes:Access to monthly newsletter with business tips, events, and member spotlightsEarly bird notifications on PBW events, programs, and challengesFree access to select virtual community meetups

$ Free for each month

Growth Member Growth MemberPrice: $29/month For: Early-stage entrepreneurs looking for affordable tools and support to grow confidently Includes: All Insider Access benefits -Access to exclusive business templates and funding resources- Access to PBW Virtual Vault (event replays, eBooks, grant lists, tools)Discounted tickets (30% off) to PBW Media Day, Roundtables, and Workshops- Access to monthly themed challenges (e.g., Build Your Business Credit Month)Ability to apply for PBW grants or speak at events (first-come, first-served)Ability to submit to be featured in “Women to Watch” spotlight -PBW Member Directory (limited view)

$29.00 for each month

Legacy Builder Legacy Builder Price: $59/monthFor: Women scaling or aspiring to scale past 6-figures or positioning for funding, exposure, and sustainable infrastructure Includes:All Growth Member benefits Monthly virtual group coaching/Q&A sessions Private masterclasses with guest experts (funding, systems, branding)VIP access to pitch grant opportunities and collaborations Quarterly “Ask an Expert” Office Hours (legal, finance, marketing)Access to the PBW Collaboration Circle (partner matching & networking)50% off all PBW events + priority seating Private portal to submit speaker pitches or host trainings Full Member Directory listing (profile, links, services)

$59.00 for each month

Power CircleAll Legacy Builder benefits Free access to all PBW-hosted events (roundtables, workshops, Media Day, etc.) 50% off all guest tickets to events Exclusive access to Power Circle Roundtables (quarterly, private strategy events) Personal introductions to capital partners, investors, or collaboration matches Private concierge support for grant/funding applications (1x per quarter) Annual feature in the Power Women Impact Report Opportunities to be featured on PBW podcast, YouTube, and event stage Full media kit listing inside PBW Speaker + Consultant Database 1 free ticket to PBW Gala or Award/Grant Ceremony

$99.00 for each month

Credit Card Details
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Credit Card Number	Security Code
Card Expiration

PRODUCTIVE BUSINESS WOMEN Membership Application (PBW)