Business/Personal Profile
Membership Type
*
Select a type
Student/Retired
Individual
Small Business
Business
Reciprocal
Provincial Patron
Member Name
Name of registering person or business to be displayed in member directory.
*
Business Category
Select all categories that best describe your business or profession.
(to select more than
one category, hold down
the
Ctrl
key when
making selections)
*
Accommodations
Accounting / Bookkeeping Se...
Administrative Support Serv...
Advertising
Antiques
Architect Services
Artist / Crafter
Auto Products / Services
Banking Services
Beauty
Bed & Breakfast
Book Publishing
Business Services
Career
Catalog / Internet Shopping
Catering / Chef Services
Cleaning Services
Coaching / Facilitation Ser...
Communication Services
Computer Training / Service...
Construction Products / Ser...
Consulting
Contractors
Dental Products/Services
Design Services
Editorial Services
Educational Services / Trai...
Employment Services
Entertainment
Event Planning / Management
Farming
Fashion
Financial Advisor
Financial Services
Fitness Services
Food / Beverage
Funeral Services
Gallery
Golf Products / Services
Government
Health & Wellness
Heating
Human Resources
Insurance
International Trade Consult...
Internet Services / Web Dev...
Legal Services
Life Insurance
Manufacturing
Marketing / Research
New Media / Film Services
News / Magazine
Non-profit Organization
Optical Services
Pet Grooming
Photography
Promotional Items
Public Policy
Public Relations
Real Estate Services
Research Services
Retail
Retail Consultant
Senior Services
Sewing Services
Strategic Planning / Busine...
Student
Tourism
Travel Services
Video Production
Other
Other Business Category
If you are applying for a Business, Reciprocal, or Provincial Patron membership, please supply the below information for your business.
Phone
*
Other Phone
Fax
Email
Email is an important means of communication for the PEIBWA. To receive full value from your membership, supply a valid email address.
*
Street/PO Box
*
City/Town
*
Province
*
AB
BC
MB
NB
NF
NS
ON
PE
PQ
SK
County
*
Kings County
Queens County
Prince County
Postal Code
*
Website
http://
Description
Give a 30 to 60 word description of yourself and/or your business. This will be displayed as part of your membership profile, visible on this website and the Member Intranet.
*
Do you wish to have your member profile listed on this website?
*
yes
no
How did you hear about the PEIBWA?
*
What is your method of payment?
*
cash
cheque
Visa
Mastercard
debit
Are you interested in serving on a PEIBWA committee?
*
yes
no
Main Contact
First Name
*
Last Name
*
Position
*
contact information below, same as above
Phone
*
Other Phone
Fax
Email
Street/PO Box
City/Town
Province
AB
BC
MB
NB
NF
NS
ON
PE
PQ
SK
Postal Code
Intranet Access
In order to access the Member Intranet, select a username and password of your choice. Once your application has been approved, you will receive confirmation that you have access to the Intranet.
Username
*
Password
*
Re-type Password
*
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