New Member Application

Company Name*

Address*

City*

State*

Zip Code*

Designated Representative*

First Last

Designated Representative Title*

Email*

Phone*

Website Address*

Brief description of company.*

(type and nature of business, location and service area, any additional information of interest)

Other Company Contacts*

Name Title Email Address

Other Company Contacts*

Name Title Email Address

Other Company Contacts*

Name Title Email Address

In applying for membership in the Partners for Environmental Progress, on behalf of*

I pledge that we agree with the beliefs of Partners for Environmental Progress: 1) That clean air and water are paramount to the health and prosperity of the Mobile/Baldwin area 2) That information concerning environmental impact must be based on facts and on sound scientific principles 3) That business, industry and the community must work together to continuously improve air and water quality in the Mobile/Baldwin area.

Dues Structure*

1-9 Employees ($275)
10-74 Employees ($500)
75-149 Employees ($725)
150-299 Employees ($965)
300-499 Employees ($1200)
500 or more Employees ($1425)

Dues for Partners for Environmental Progress, Inc., are based on the number of local full-time employees. If your employee base fluctuates or is weighted by part-time employees, please use an average number of employees. Dues are payable on a calendar year basis and are due when invoiced. Invoices will be forwarded upon approval of membership application. Please check the appropriate box above. Partners for Environmental Progress, Inc. is a 501 (c)(6)(non-profit) organization.

Owner/Manager Approval*

I am the owner/site manager, and I acknowledge PEP Membership.

(Please have the owner/site manager of your company check the box above.)

Owner/Site Manager Contact Information*

Name Title Email Address

Referred By:*

New Member Application

Membership Application