Basic Membership Application

Membership Application

Please complete the following and submit
Company Name
Contact Name

First NameLast Name
Referred BY
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
What is the best way to reach you?
(Phone, email or text?)
Website URL
Directory Listing

Please complete the following for your online listing. You may submit your description at a later date.
Category
1st one is free, each additional is $20
2nd Category (if applicable)
3rd Category (if applicable)
Please write a 75-word description that will appear on your listing. You may submit this at a later date to julia@afwpi.com.
If you would like us to pull your description from your website, write "see website"
Licenses & Permits

Please list those that are applicable.
Business License Number & City where obtained
Resale #
Health Licenses & City where issued (if applicable)

Membership Application