Member Application

Please complete this form to make payment for your new or renewal membership. We allow for check or credit card payment. After you complete the form you will receive a confirmation email.

Registration Type*
Corporate rate includes 2 or more individuals from the same company.
Number of Members*
Select total number of members from your company
Personal Information
This information will be used for Baltimore Public Relations Council purposes only.
Name*
First Last
Additional Member Names*
Email*
Phone*
Preferred phone number
Employment Information
Company*
Title*
Company Address
Street Address City State ZIP Code
Company Phone*
Educational Information
College or University*
Major*
Type of Membership
You have selected the following membership type
Professional*
Price: $90.00
Corporate (deprecated - for archived purposes only)
Price: $90.00
Corporate
Price: $0.00
$90 for first membership, $75 for each additional
Student*
Price: $45.00
Retiree
Price: $45.00
Half Year (Jan. - July)
Price: $45.00
Total
$0.00
Payment Information
Please select your payment method below
I would like to pay by:*
- Check
- Credit Card
Once you complete this form, write a check and make payable to 'Baltimore Public Relations Council' for the amount due. Mail check to 2331 Emory Road, Reisterstown, Maryland, 21136
Please complete your payment on this page. You are required to enter the billing address of the credit card used.
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Captcha
Email
This field is for validation purposes and should be left unchanged.

Personal Information

Employment Information

Educational Information

Type of Membership

Payment Information