Please list the company name exactly as it should be listed in the Professional Alliance Directory.
Please enter this information - including name, address, phone number and e-mail, as it should be listed on the directory of Professional Alliance members.
Use the additional comments field at the bottom of this form for the following:
If you would like a description of your services to appear with your website listing, please send a 50 word description to email@example.com.
Professional Alliance Memberships are valid for one year. If you would like your membership to automatically renew, select "Annually" under donation frequency.
To have your company logo displayed on the website next to your listing, please add $300 to the cost of the membership level in the "Other" field, and e-mail the logo in .jpg format to firstname.lastname@example.org.
Please select the categories under which your company will be listed. Due to space constraints, the selection of additional categories beyond the maximum allowable will be disregarded.