Business/Personal Profile Membership Type * Select a typeStudent/RetiredIndividualSmall BusinessBusinessReciprocalProvincial 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) * AccommodationsAccounting / Bookkeeping Se...Administrative Support Serv...AdvertisingArchitect ServicesArtist / CrafterAuto Products / ServicesBanking ServicesBeautyBed & BreakfastBusiness ServicesCareer Catalog / Internet ShoppingCatering / Chef ServicesCleaning ServicesCoaching / Facilitation Ser...Communication ServicesComputer Training / Service...Construction Products / Ser...ConsultingContractorsCorporate CommunicationsDental Products/ServicesDesign ServicesDistilleryEditorEducational Services / Trai...Employment ServicesEntertainmentEvent Planning / ManagementFarmingFashionFinancial AdvisorFinancial ServicesFitness ServicesFloristFood / BeverageFundraisingFundraising/Grant WritingFuneral ServicesGalleryGolf Products / ServicesGovernmentGraphic DesignHealth & WellnessHistorical ServicesHuman ResourcesInsuranceInternational Trade Consult...Internet Services / Web Dev...LandscapingLegal ServicesLife InsuranceManufacturingMarketing / ResearchMarriage CommissionerMedia / Social MediaMedia/Social MediaMediation & Conflict Resolu...Museum/Archival ServicesNew Media / Film ServicesNon-profit OrganizationOffice Furniture & SystemsOptical ServicesPet GroomingPhotographyPlumbing/Heating Contractin...PotteryPrintingProfessional OrganizerPromotional ItemsProperty ManagementPublic PolicyPublic RelationsPublishingReal Estate ServicesRehabilitation & Medical Ne...Research ServicesRetailRetail ConsultantScriptwritingSecuritySenior ServicesSewing ServicesShowroom Sales & Installati...SpeechwritingStrategic Planning / Busine...StudentTourismTravel ServicesVideo ProductionWriterOther Other Business Category Phone * Other Phone Fax Email * PEIBWA communicates with our members by email only so please provide 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   Description * Give a 30 to 200 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 Extranet. To add a hyperlink to your profile description (a clickable link), simply type the text you want clickable (eg. "Website Name"), highlight the text, and click the icon to enter or paste the website or email address (eg. www.website.com).     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  PayPal   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   Extranet Access In order to access the Member Extranet, select a username and password of your choice.  Once your application has been approved, you will receive confirmation that you have access to the Extranet. Username * Password * Re-type Password *         Please enter the number you see in the box below *