THIS FORM IS FOR CURRENT MEMBERS TO RENEW ONLY. NEW MEMBERS USE THE FORM ON JANUARY 1st TO JOIN THE ASSOCIATION.
You MUST use the billing address for the credit card to process this charge. If you want your mailing address to be something other than the one associated with the credit card please add that to the comment field or email the office.
THIS IS FOR NEW MEMEBERS ONLY - Current Members use January 3 to renew
You MUST use the billing address for the credit card to process this charge. If you want your mailing address to be something other than the one associated with the credit card please add that to the comment field or email the office.
You will need to enter the billing information for the credit card on the registration form. If you have alternate information for the person you want as the contact for the Preferred Vendor Plan please also complete this form and email it to epwpcoa@ptd,net.
To pay by check complete this form and mail it will a check to EPWPCOA 244 Mountain Top Rd Reinholds, PA 17569.
You can renew online with a credit card but if you are a new sponsor or if you have any changes to your current listing you will need to also complete and submit this form.
The information you type in for the credit card payment should be the billing information for the card. Your contact information will be completed on the form above.