RPIA Application Form

The RPIA Group - It doesn't cost . . . it PAYS!^TM

Brain Trust - Peer Group - Buying Group
Our Members Represent Over 700 Store Fronts in the USA

RPIA Gold Application Form
$750 ($250 App fee plus 1 year dues of $500)

After completing the below application
Please click the "Online Store" Tab on our Home Page and Pay for Your Gold Membership.
Or Click Here to Go to Our Online Store

RPIA Application Fee - required to take advantage of RPIA rebate and discount programs, etc.

All information will be kept confidential. RPIA members are represented as having sales volume of over 1 million dollars per year and paying all invoices within 30 days of receipt of merchandise. To assure RPIA buying power any member unwilling or unable to meet these terms may be asked to withdraw from RPIA. As a condition of membership you will be asked from time to time to complete a survey of your usage of certain products. You will also be asked to sign a confidentiality form and a W-9 form as part of your membership.

Gold Application Form

Click Edit Form to add form elements. You can enter a form description and instructions here.

Contact 1 first name:
Contact 1 last name: *
Contact 1 email address: *
Contact 2 first name:
Contact 2 last name:
Contact 2 email address:
Company name: *
Doing business as:
Web Site (www.yourdomain.com):
Address Line 1: *
Address Line 2:
Address Line 3:
City: *
State (2 letters): *
Zip Code: *
Business Phone: 999-999-9999: *
Business Fax: 999-999-9999:
Cell Phone: 999-999-9999:
Annual Sales Volume (min 1 million dollars): *
Avg monthly mix usage (in pounds):
Type business: (retail bakery, deli, etc): *
Sq Ft of storage for materials:
Number of locations:
Have central plant for deliveries? (Y/N):
Have a loading dock? (Y/N):
Have Pallet Jack? (Y/N):
Can handle palletized delivery? (Y/N):
Have a Hi/Low? (Y/N):
How often do you order most materials:
Billing Address Same? If not, enter below (Y/N):
Billing Company Name:
Billing Address Line 1:
Billing Address Line 2:
Billing Address Line 3:
Billing City:
Billing State (2 letters):
Billing Zip Code:
Tell us about yourselves; experience; years of baking; goals for joining RPIA; programs of RPIA you are interested in.:
Invited By (you need not be invited to join):

The RPIA Group
PO Box 803, Westfield, IN 46074
Phone:(800)746-6551 FAX:(888)-552-6206
rick.crawford@rpiausa.org