2026 PNBA Sales Rep Membership Form

2026 PNBA Sales Rep Membership Form

Sales Representative
This form is for the Sales Rep Membership,

which includes a password-protected profile in our Member Handbook.

The Publisher / Company Membership is a separate form and offers different types of benefits, including a public-facing Publisher / Company listing on PNBA.org.

If you you have multiple Reps covering multiple lines / imprints for the PNW, please invest in a membership for each to secure priority for Rep Pick opportunities.

Memberships generally run January 1 - December 31.

However, memberships purchased post-Tradeshow are valid for the following year.

Sales Rep Member Benefits are outlined under our

Membership Tracks.
Sales Rep Name*

First NameLast Name
Company Name*
For Authors, this may be your Name again.
Sales Rep Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Sales Rep Phone:*

Area CodePhone Number
Sales Rep E-mail:*
Company Website:
Please submit a Rep photo and Company Banner for your profile in the password-protected Member Handbook portion of our website.

Up to 10 MB photo.
Rep Photo:

Browse Files
JPG or PNG Cancelof
Company Banner:

Browse Files
JPG or PNG Cancelof
Rep Territories, Lines, and Imprints (alphabetically):
New profile = no character limit. Existing Sales Rep profile: please review and list items to add or subtract.
Additional Comments
Payment
Sales Rep Membership
Total
Total Payment

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2026 PNBA Sales Rep Membership Form

Payment