Membership Application

Arkansas Pawnbrokers Association

1123 South University, Suite 101

Little Rock, AR 72204

Questions? Call 1-800-497-4548

Name of Business: __________________________________________________

Address: ______________________________ City: _______________________

County: ____________________ State: ________ Zip code: ________________

Phone: _____________________ # of locations: ______ # of employees: ______

Principal Owner(s): __________________________________________________

Manager(s): ________________________________________________________

FULL MEMBERSHIP

          ( ) Enclosed is $325.00 for my annual dues and membership fees *

ASSOCIATE MEMBERSHIP

          ( ) Enclosed is $100.00 for annual dues and membership fees **

ADDITIONAL STORES

          ( ) Enclosed is $100.00 for each additional location fees.

* Person or Company doing business in the State of Arkansas as a pawnbroker.

** Person or Company engaged in a business related to or associated with pawnbrokers.