NKBPA Membership Application

NKBPA Membership Application

Annual Membership is $60 per year, per business location for up to 2 representatives. A corporate membership is $150 for 3+ representatives. Membership includes listing in our online members list. Advertising on our website email camera ready artwork for directory ads to nkbpa.info@gmail.com. Membership payments must be submitted by February 28, 2024.
Business Name*
This is how your business is listed in the directory and on the membership badges
Business Website
www..example.com
Business Representative (will attend meetings)*

First NameLast Name
Business Representative Email
example@example.com
Business Phone Number
Representative Best Contact Phone Number (not to be published in the directory)
Business Address (Physical business location)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different from business address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Optional

List an additional representative contact below:
Representative 2 Name

First NameLast Name
Rep 2 Email
example@example.com
How will you pay?*
If paying by credit card online, don't forget to click "submit" to process your payment. A copy of this form will be emailed to you. You can mail checks to PO BOX 27479, Knoxville TN 37927-7479. Please include a completed membership form with your check if you plan to mail payment.
If you are paying for a corporate membership please list other representatives and their email for who will attend.

Membership and/or Website Ads

Membership/RenewalMembership per business location for up to 2 representatives

$60.00

Corporate MembershipMembership for 3 or more representatives

$150.00

Directory/Website ad small

$75.00

Directory/Website ad large

$150.00

Total

$0.00

Credit Card

If you are not paying by credit card (above) or if there is a problem submitting please print this form and mail it with your check OR bring it with you to the next meeting and pay by check or credit card in person.

Make checks payable to NKBPA and mail checks and ads to:
ATTN: Membership, PO BOX 27479, Knoxville, TN 37927-7479
Email ads or questions to nkbpa.info@gmail.com

Your membership makes a difference in our community. Join today!
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