Distributor Membership Application Form

Instructions

**APPLICATIONS ARE FOR NEW MEMBERS ONLY. IF YOU ARE RENEWING YOUR MEMBERSHIP, PLEASE CONTACT THE OFFICE AT INFO@MBDAPA.ORG AND WE WILL FORWARD YOU AN INVOICE.**

Click on box next to "Distributor Membership" and select the level that represents your Gross Sales. In establishing MBDA's dues structure, every effort was made to consider all business sizes. For the dues structure to work, it is imperative that your payment accurately reflects your TOTAL gross sales volume.

Select An Option

Distributor Membership

Select Level

For Distributors (D) and Importing Distributors (ID):

Level 1: Annual gross sales under $500,000 ($570 yearly)

Level 2: Annual gross sales of $500,000 to $1,000,000 ($780 yearly)

Level 3: Annual gross sales of $1,000,001 to $2,000,000 ($995 yearly)

Level 4: Annual gross sales of $2,000,001 to $3,000,000 ($1,205 yearly)

Level 5: Annual gross sales over $3,000,000 ($1,425 yearly)

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

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