Conference Advertising Application Form

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Company Name: *
Contact Person: *
Contact Number: *
Email: *
Web Address: *
Address: *
City: *
Zip/Postal Code:
Country *
Advertisement Type: *
Advertisement Dollar Amount: *
If providing a tote bag insert, please describe the type of insert you wish to provide (collateral, pamphlet, tangible item). All inserts must be approved by the PMA prior to insertion.
(Maximum characters: 2000)
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Payment Information:

Choose method of payment:

Payment by Credit Card:
You can submit your credit card information one of the three following ways:
1. Download the credit card authorization form provided below, complete and re-upload prior to submitting the application.
2. Fax to 305-573-4461, attention Maly De Jesus
3. Email directly to Maly De Jesus at

Please note applications submitted without payment information will not be processed until payment info is received.

Payment by Check:
Only checks drawn on US banks are accepted and must be made out to: Pilates Method Alliance.
Please send check to PMA, 1666 Kennedy Causeway, Suite 402, North Bay Village, FL 33141.


Please upload your completed credit card authorization form here.
I authorize the Pilates Method Alliance to process my payment (check or credit card). I understand this constitutes a legally binding agreement. I further certify that the application information above is true and complete, and that I am authorized to sign on behalf of the above listed company. I understand that falsification of any of the information may result in the revocation of listing. *

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