US Pizza Team Gold and Silver Affiliate Member Information Question Title * 1. Contact Information Name Company Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Email Address Phone Number Question Title * 2. Website Question Title * 3. Job Title/ Position: Question Title * 4. Which best describes your operation? Independent Operator Franchise Operator Chain Operator Chef/Educator Other Question Title * 5. Year Joined the Team 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 Question Title * 6. Please enter your Pizzeria's username on each of the following Social Media Outlets Facebook Twitter Instagram Pinterest Linked In Snapchat Question Title * 7. T-Shirt Size Adult Small Adult Medium Adult Large Adult X-Large Adult XX-Large Adult XXX-Large Other (please specify) Question Title * 8. Your Membership includes a 1 year Free Subscription to PMQ Pizza Magazine I DO wish to subscribe or continue receiving a print subscription to PMQ Pizza Magazine at the address above. I DO NOT wish to receive a Free one year subscription to PMQ Pizza Magazine. Question Title * 9. In lieu of signature, what day of the month were you born? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Thank you and Go Team USA! For further information or questions email join@uspizzateam.com. Done