US Pizza Team Competing Member Information

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* 1. Contact Information

Name

Pizzeria

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Website

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* 3. Job Title/ Position:

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* 4. Which best describes your operation?

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* 5. Year Applying to the Team

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* 6. Please enter your Pizzeria's username on each of the following Social Media Outlets

Facebook

Twitter

Instagram

Linked In

Snapchat

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* 7. Publicity Contact

Name

Email Address

Phone Number

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* 8. Personal Sponsors: (if any)

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* 9. Primary Competition Skills

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* 10. Secondary Competition Skills

Fastest Pie Maker

Fastest Box Folder

Largest Dough Stretch

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* 11. Brief Bio for Website Profile

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* 12. T-Shirt Size

Other (please specify)

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* 13. 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.

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* 14. In lieu of signature, what day of the month were you born?

Please send an updated photo for your website profile to join@uspizzateam.com.

Competing Member Applicants are in pending status until approved by committee.

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* 15. This application is subject to review and approval by the USPT Council. Your card will not be charged until approved.

Credit Card Number

Expiration Date

Name as it appears on Card

Billing Street Address

City, State and Zip Code

Card Security Code