Membership Signup Form

Membership Dues Now $135.00 per year

To become a member, complete this form, press the "Submit Listing" button and make your membership payment in one of three ways:

*Option 1*	*Option 2*	*Option 3*
Pay by credit card by visiting the PWN Store. (It's easy! Simply follow the directions upon completion of the form below.)	Mail a check to PWN PO Box 1489 Seaside, CA 93955	Bring a check to our next meeting! Make it payable to "PWN".

If you choose payment options 2 or 3, you do not need to do anything further after you click the "Submit Listing" button at the bottom of the application.
For online credit card payment, follow the instructions given after you click "Submit Listing".

Type the information below as you wish it to appear in the PWN Directory.

YOUR LOGIN INFORMATION
Email Address:
Password: Choose your own!
Confirm Password:
YOUR NAME & JOB TITLE
First Name:
Middle Name:
Last Name:
Suffix:
Job Title:
BUSINESS MAILING ADDRESS
Company Name:
Address 1:
Address 2:
City:
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Zip:
PHYSICAL ADDRESS (IF DIFFERENT TO MAILING ADDRESS)
Address 1:
Address 2:
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Zip:
INFORMATION ABOUT YOUR BUSINESS
Category 1:
Category 2:
Phone 1:
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Fax:
Website:
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How did you hear about us?
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Professional Women's Network of the Monterey Peninsula.
PO Box 1489 Seaside, CA 93955