Membership Payment Plan

Membership Level

Please select the membership level you would like to sign up for. Regular memberships are reserved for brick-and-mortar only. Cost is $27.50 per month for 12 months. Aspiring Shopkeeper memberships are $23 per month for 12 months.

Name

First Name

Last Name

Business Name

Phone

(###)

###

####

Credit Card Type

Cardholder Name

Credit Card Number

Expiration Date

3-Digit Code

Billing Address

Billing Zip Code

I authorize ISA to charge my credit card above for the purchase of an annual membership billed monthly for 12 months. I understand that my information will be saved to file for future transactions on my account. I also understand that failure to pay will result in termination of my membership.

Independent Shopkeepers Association Inc.

ISA IS A PROUD PARTNER OF: