Pay by Credit Card or PayPal
(with $6 Service Fee)

Complete the application and then click the “Submit” button to make a secured payment using your credit card or PayPal account.  A copy of your completed application and receipt will be emailed to the address on the form.

Company Name:*
Contact Person & Title:*
Address:*
Phone:*
-
E-mail:*
Include email address in directory?*
Website:*
Business Description (up to 80 characters):
The information below will not be released to the public, but it will help PPBIC deliver important information (safety alerts, emergencies, relevant meetings, etc.) to the appropriate people.
Number of Full Time Employees:*
Number of Part Time Employees:
Main Contact Name, Telephone, and Email Address if Different from Above
Facilities Manager Name, Telephone, and Email Address:
HR Manager Name, Telephone, and Email Address:
Member Type:*
Convenience Fee *
Total:
Answer math problem. Then press Submit. The SECURE PAYMENT PAGE will appear in a few seconds. To Pay with Debit or Credit Card, scroll to bottom of the Secure Payment Page.

Pay by Check

Click the button below to download the application form.  Send that form along with your check to:

Peterson Pulaski Business & Industrial Council
5724 N. Pulaski Road
Chicago, IL  60646

Download Form