MEMBERSHIP APPLICATON SUBMISSION
Portsmouth Business Association, Box 314, Portsmouth, RI 02871

PLEASE COMPLETE THE APPLICATION BELOW. Dues are $60.00 per calendar year. Secondary Classifications are an additional $5.00 per year. Payment is accepted via credit card through secure on-line processing by PayPal®.

You may download the membership application in .pdf format here.

Thank you for your participation... the Portsmouth Business Community values your involvement!

PLEASE INCLUDE THE FOLLOWING INFORMATION

Items in red are required

Name or Business name
Email Address:
Contact Name
Contact Address
City, State & Zip
Phone Number
Fax
Business Category	----Choose Category ----- Accountants Antique Restoration Antiques Arts And Artists Assisted Living Attorneys Auto Accessories Auto Repair Auto Sales Banking Busines Development Chambers Child Care Chiropractic Concierge Construction Contractors Dance Decorating Defense Contractors Dentist Diesel Engines Dry Cleaners Entertainment Event Accommodations Finance Financial Planning Fitness Florist Funeral Home Garden Supplies Garden Supply Golf Course Graphic Design Grocery Store Hail Salon Home Staging Insurance Insurance/Investment Landscaping Law Offices Liquor Store Manufacturing Marine Marine - New Boat Construction Marketing Marketing & Advertising Music Organizations Paint your own Pottery Painters Pet Care Photography Picture Framing Pizza Printers Private Club Promotions Real Estate Rentals Restaurant Retail Sailing Scolarship Septic Systems Shoes Signs Tent Rentals Towing Travel Agency Used Car Sales Utility Vacuum Sales/Repair Vending Machines Vineyards Visiting Nurses Web Site Design Weight Loss Wholesale/Imports Womans Boutique Writer
# of Employees	self 1-4 5-10 10+
Type of Business	Corporation Proprietorship LLC Partner
Comments or Questions
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