Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max):

Directory Category:

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Fax:

Email:

Contact Preference:

Email Phone

Login:

Password:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

1-3 Employees: $175.00
Business Membership 4-9 Employees: $220.00
Business Membership 10-25 Employees: $280.00
Business Membership 26-50 Employees: $420.00
Business Membership 51-100 Employees: $490.00
Business Membership 101-Over: $575.00
Business Membership Charity: $140.00
Any non-profit organization formed for charitable purposes may join for $140.00 per year and will receive the monthly newsletter, plaque, and will be listed by organization name in the chamber directory. Same Owner/Associate: $110.00
Same-Owner Business/Associate (Must have an active main membership currently to qualify for a Same-Owner Business Associate Membership)

Additional Fees:

New Member Registration Fee : $25.00
This will be a one-time fee

Additional Opportunities:

We will contact you with additional information.

Do you want a membership plaque? : $0.00
If yes, there is no extra cost.

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address