2021 Directory Form

Please select one of the following options: *

Check this box if you had an ad in the 2020 KPBA Member Directory. You qualify for a free ad of the same size in our 2021 Member Directory.
No cost - Basic Directory Listing included with your annual membership.
$50 - Directory Listing with embedded links to your website and social media (expires on your KPBA anniversary)***Purchase an ad and this fee waived!***
$150 - Don't have a website? We'll create a page on ours for you. You provide pictures, coupons, job postings, etc.; we'll do the rest!

Company Name *

Representative Name *

First

Last

Street Address

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Which address do you want listed in our Directory? *

Physical Address
Mailing Address
Do not list an address.

Main Phone Number To Be Listed in Directory *

Fax Number

Mobile Number - Enter only if you want this listed in Directory.

Is it okay to text this number?

Email - To Be Listed in Directory *

Email

Confirm Email

Business License #

Professional License #

Residential Endorsement #

Website / URL

Facebook

Instagram

Twitter

Type of Business *

Include all services your company performs, use a comma between each.

Brief Company Bio - Please include key words and categories to make your company easier to find using our built-in search engine online.

Include Year started, date of Membership, etc.

Are you interested in volunteering to be on a committee? Check all that apply. We will contact you with additional information.

Are you interested in being a guest speaker at a Members Meeting? *

Yes
No

Categories (choose as many as you would like for the online directory):

Use this area to enter up to THREE categories for your printed directory listing. Also use this space to make suggestions for additional categories.

Would you like to submit an ad in our Directory for print & online? ***NOTE: Purchase of an ad waives the "$50" fee for embedded links in your online directory listing.*** *

Please select one option if interested. All ads will be linked to your choice of website or social media in the online Directory. The online Directory will be updated monthly to reflect current members and any changes submitted by members. Ads will be run online for one year from original posting date and in all printed copies.

Would you like us to create the ad for you? We charge $100 per ad. You get to keep the ad for use on your other platforms (social media, webpage, newspaper, etc.).

Yes
No

Upload your logo in a .jpg or .png format

Click or drag a file to this area to upload.

Already have an ad? Upload it here.

Click or drag a file to this area to upload.

Please sign your name, attesting everything above is true and accurate. *

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