Pyrotechnics Guild International, Inc.
PGI MEMBERSHIP APPLICATION
The Pyrotechnics Guild International (PGI) is a Not-for-Profit Fellowship founded in 1969 and
incorporated in 1974 – dedicated to the Advancement of Safety, Skill, and Artistry in Fireworks through
Communication, and for the preservation of fireworks in America and throughout the World.
Send the completed application to:
Frank Kuberry, Secretary-Treasurer
Pyrotechnics Guild International, Inc.
304 West Main Street
Titusville, PA 16354
Name _____________________________________________________________________________________
Address ____________________________________________________________________________________
City _________________________________________________State _____Zip Code ___________________
Phone (Home) (_____) ________________________ Phone (Work) (_____)____________________________
Date of Birth _____________ Were you a PGI member in the past? _________________
Occupation ________________________________ Employer ________________________________________
My primary reason for joining the PGI is: _________________________________________________________
___________________________________________________________________________________________
Please complete either A or B.
A. PGI member who is recommending you as a member _____________________________________________
B. List names and addresses of 3 personal references other than family or relatives.
1. ______________________________________________________________________________________
2. ______________________________________________________________________________________
3. ______________________________________________________________________________________
I certify that the information in this application for membership is true and complete and accept that false statements are grounds for
revocation of membership. I enclose my annual dues payable to the PGI for membership in the class that I have circled below:
Full & Junior Membership - With PGI Bulletin $50.00**
Full & Junior Membership - Without PGI Bulletin $15.00*
Initial membership or tardy renewal later than 120 days past your last date of membership in the PGI is $50. On-time annual renewal is
$30 per year.
Payment may be made by credit card (Visa or Mastercard only)
Credit card # ______________________________________ Expiration Date _________________________
In order to be eligible to attend the PGI annual convention in August you must have been a paid-up member by June 1 of the convention
year you wish to attend.
* Membership without the PGI Bulletin is only available when another member of the household is receiving the PGI Bulletin.
** If you are under 18 years of age and applying for Junior membership, you must enclose written permission from your parent or legal
guardian to join the Guild.
Signature _____________________________________ Date ______________________________________