New Member Application Step 1 of 6 16% New Member ApplicationPNA is a networking group based in Gaithersburg, Maryland which reaches and includes businesses and business members from the greater Central Maryland region. The overall purpose and goals of this group include but are not limited to the following: To maintain and grow a group of like-minded professionals; To support and encourage group members in their businesses and professional pursuits; To support group members with business leads and referrals; and To provide a structured setting that empowers group members with confidence toward their achieving their business goals. Please do not submit your application until you have visited our group at least once! You can find a meeting to attend on our Events Calendar.Consent(Required)PNA makes no guarantees to the Applicant. The submission of this Application does not guarantee the Applicant membership in PNA, nor does it guarantee the Applicant business referrals, business leads, or any monetary gain as a result of membership in PNA. PNA is a group designed to help members grow and gain confidence in their businesses and goals, but it cannot guarantee that an Applicant or future member will achieve any of these goals. PNA is only a supportive networking group, and it is not a business in and of itself designed for profit. Any monies it receives from its members are used to continue the goals of the group as a whole and its agreed-upon ventures, including but not limited to, group functions and meetings and public services. I have read and understand the above and wish to submit my application! Applicant's InformationName(Required) Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Suffix Business Name(Required) Professional Title/Postion/Role(Required) Cell PhoneOffice Phone(Required)Business Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Applicant's Email Address(Required) Enter Email Confirm Email Website Sponsoring MemberEnter the name of the PNA member who invited you to apply to the group Networking MembershipsPlease list all networking groups in which you are a member. Add Remove Professional Background and ExperienceBusiness CategoryPlease state the specific type of business that you want to represent and put forward in this networking group Number of years with current company(Required)Number of years in industry(Required)Experience(Required)Please describe your experience in your current business (Applicant may include a resume with this Application below)Education and Certifications(Required)Please describe your education and/or certifications in this industry.ResumeOptionally, you may upload your resume.Accepted file types: pdf, Max. file size: 512 MB. ReferencesTo ensure the Applicant is a good fit for PNA and that the Applicant is an upstanding business professional who could and would be committed to this networking group and its members, you will be required to submit two professional references. The PNA Membership Committee will be contacting these references. Reference 1 of 2Name Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Business Title PhoneEmail Relationship to Applicant Number of Years KnownPlease enter a number from 0 to 50.Reference 2 of 2Name Dr.MissMr.Mrs.Ms.Prof.Rev. Prefix First Last Business Title PhoneEmail Relationship to Applicant Number of Years KnownPlease enter a number from 0 to 50. Applicant Agreements and UnderstandingsI, the PNA Applicant, do hereby agree to the following statements upon submission of my application: (Required) I understand and agree that submitting my application does not guarantee my membership in PNA(Required)(Required) I understand and agree that the Membership Committee will contact my business references.(Required)(Required) I understand and agree that, if I am accepted as a member of PNA, I will treat all Members and visitors with respect and professionalism.(Required)(Required) I understand and agree that, if I am accepted as a member of PNA, I will pay the Membership Fee of $500.00/year.(Required)(Required) I understand and agree that the Membership Fee is non-refundable once paid.(Required)(Required) I understand and agree that, if I am accepted as a member of PNA, I will pay the quarterly meeting dues and that these dues are in addition to the annual membership fee.(Required)(Required) I understand and agree that payment of the Membership Fee does not guarantee my continued membership in PNA and that my membership may be terminated for violations of the code of conduct.(Required)(Required) I understand and agree that the meeting dues are non-refundable once paid.(Required)(Required) I understand and agree that I will actively work to give referrals to other Members of PNA and will promptly follow up on the referrals that I receive from other PNA members.(Required)Signature(Required) Δ Facebook Twitter LinkedIn
