Membership Fees:

  • One Time Application Fee: $50
  • Prorated Annual Dues: $180 if paying between January and June  /  $90 if paying between July and December

 

First Name * Required
Last Name
Comments

Name of Applicant:

Please list the name of the applicant as it should be listed in our Business Partner Directory.

First Name
*
Last Name
*

Business Name:

Please list the name of the business as it should be listed in our Business Partner Directory.

*

Business Address:

Please list the address as it should be listed in our Business Partner Directory.

Street Address
*
City
*
State
*
Zip Code
*

Phone Number:

*

Fax Number:

Fax Number is optional.

Email:

*

Company Website:

Please list your company's website (optional).

Type of Business:

*
Other

I Will Be Paying:

$140.00

Please note: The above total fee includes a one-time $50.00 application fee.

Payment Type:

We accept Cash, Check, Visa or Mastercard.

  • Check - Please make check payable to "PGPCNP Association".
    Mail your payment to the Association office or pay in person at:
    3320 Loveland Blvd. Port Charlotte, FL 33980.
     
  • Credit Card (Please call Sonya Addison, Membership Coordinator, at 941-258-3041 to pay over the phone.)

Agreement:

*

Comments/Special Request:

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