Pay by Credit Card or PayPal
(with $8 Convenience 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:

The following is the Membership Fee Calculator, Online Convenience Fee, plus an Opportunity to Donate to PPBIC to bridge the gap left by no 2020 fundraisers.  Thank you in advance for your generosity.


Member Type:*
Convenience Fee: *
Donation:
Other Amount:
 $ 
 . 
Total:
Answer math problem and then press Submit. Wait a few seconds for the Secure Payment Screen to appear.

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