contact us

We would love to hear from you.  Just message us with the form to the right and we will respond as soon as possible.


2400 Linglestown Rd, STE 302
Harrisburg, PA, 17110
United States


Membership Application / Renewal

Welcome to the 2015 Membership Application or Renewal.  For questions, please give us a call at 717-909-1958.

Primary Contact Name *
Primary Contact Name
CEO/GM/President Name
CEO/GM/President Name
Compliance Officer
Compliance Officer
Company Information
Tell us a little about your company
Company Mailing Address *
Company Mailing Address
Company Phone Number *
Company Phone Number
Membership Levels
2015 PAMS Membership Levels *
Membership Levels are based on the Total 2014 PA Sales
Would you like and invoice sent to you? *
If you would like an invoice sent to you, it will be emailed to the primary contact within a business day.
Payment Options *
If you are paying by check, once you press submit, your form as been sent and your registration is complete. If you are paying by card, once you hit submit, it will take you to the payment portal.
Nature of Business
Product Lines that Apply to your Company
Accrediting Company