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: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Instagram

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: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Instagram

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Home Based: $195.00
Home Based Business Non Profit Organization: $120.00
Non Profit Organization Under 5 Employees: $295.00
Under 5 Employees Under 20 Employees: $345.00
Under 20 Employees Under 50 Employees: $410.00
Under 50 Employees Under 100 Employees: $475.00
Under 100 Employees Over 100 Employees: $595.00
Over 100 Employees Associate Member: $120.00
Retired Individuals, Clergy, elected officials & community members

Additional Opportunities:

We will contact you with additional information.

Lunch Tickets : $240.00
Order your pre-paid lunch ticket for upcoming membership meetings. Can be used 10 times at monthly, Progressive or Annual meetings. Cost $240. (Valued up to $350) Ladies Night Out : $0.00
Be a vendor at Ladies Night Out Event. (You will be contacted) Senior Luncheon : $0.00
Be an event sponsor, lunch sponsor or volunteer. (You will be contacted) Fall Community Fest : $0.00
Become a vendor during this event in September. (You will be contacted) ChamberFest : $0.00
This event is a community wide event. Participate as a vendor, volunteer, sponsor, etc. (You will be contacted)

Payment Option:

Charge my credit or debit card

Member Application

Mailing Address

Address

Address