Member

Your annual investment in chamber membership is based on the number of full time employees. Here is the fee schedule for reference: 1-10 $300; 11-20 $380; 21-49 $525; 50-99 $660; 100-199 $785; 200-399 $900; over 400 $1,200; Additional Members $250; Home-based business $250; Non-profit $200; Individuals $200.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website: *

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

Referred By:

Interested in Legislative Issues:

Interested in Advertising or Sponsorship Opportunities:

Interested in Small Business financing programs:

Interested in participating in a Committee:

Do you have a Facebook page for your business:

Do you participate in LinkedIn:

Can you reommend a business partner or associate who could benefit from Chamber Membership:

Comments:

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: *

Social Networking:

LinkedIn Facebook Twitter

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

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: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Print Application

Member Application

Mailing Address

Address

Address