Chamber Membership Application Primary Contact This section is for the individual member's contact information. There is a section below for the business or organization general contact information. First Name * Last Name * Title Real Estate Agent/Broker for Chamber Member Company Yes * * *ADDING A NEW OR CHANGING THE EXISTING EMAIL ADDRESS IN THE FIELD BELOW WILL CHANGE YOUR LOGIN EMAIL ADDRESS. * * * Email Address * Put your contact email address here, NOT the organization's email address. The password field below is for new members registering online for the first time. * * * Existing Members: Use the Lost your password function at login. The system will email you a password reset. * * * Password (This password field is for new members registering online for the first time. If you are already a member of the website, please use the "Lost Password?" link on the login page to change your password. Daytime Phone Mobile Phone PLEASE ENTER PHONE NUMBER LIKE THIS EXAMPLE: 888-123-4567 Company Info Business Name or Organization Name * Enter our organization name as you would like for it to appear in the online member directory. Number of Full-Time Employees Number of Part-Time Employees (2 PART-TIME EMPLOYEES EQUAL ONE FULL-TIME EMPLOYEE) Business Logo Drop a file here or click to upload Choose File Maximum upload size: 52.43MB Business Category * Arts / Crafts Assisted Living Automotive Bank Community Services Construction Consulting Dining Education Electrical Entertainment Equestrian Financial / Accounting Foundation Health Home / Garden HVAC Industry Insurance Legal Lodging Media Medical Museum Non-Profit Plumbing Printing Real Estate Recreation Retail / Shopping Technology Transportation Travel-Tourism Utility Winery Websites / Social Media Marketing Security (CLICK DROPDOWN AND SELECT ONE CATEGORY AT A TIME . SELECT ONLY 3 TOTAL CATEGORIES) Business Description Keywords (Word that describe your business niche, separated by a comma) Business Location Location Street Address * (PLEASE DO NOT USE A PO BOX IF YOU PROVIDE PRODUCTS OR SERVICES AT YOUR BUSINESS LOCATION ADDRESS; YOUR MAILING ADDRESS SHOULD BE ENTERED IN THE BILLING ADDRESS SECTION. Location City * Location State * Location Zip Referred by: Business Phone * PLEASE ENTER PHONE NUMBER LIKE THIS EXAMPLE: 888-123-4567 Business Fax (if applicable) PLEASE ENTER PHONE NUMBER LIKE THIS EXAMPLE: 888-123-4567 Business Main Email Address (Example: name@mydomain.com) Business Website URL Example: http://www.mywebsiteaddress.com MUST INCLUDE http:// Business Hours Days & Times Example: Mon.-Thurs. 9 am-5pm; Fri. 10 am- 6 pm; Saturday 10 am- 2pm; Closed Sunday Social Media (CLICK THE TITLE ABOVE TO OPEN THIS SECTION) LinkedIn URL Google+ URL Facebook URL Twitter URL Business Mailing / Business Address Billing Email * My Business Mailing / Billing Address is: Same as Location Address Billing Address Billing City Billing State Billing Zip Billing Contact Name Billing Phone Membership Level & Fees INVESTMENT SCHEDULE 1-10 Employees $199 11-25 Employees $259 26-150 Employees $359 Over 150 Employees $559 Bank or Utility $559 Non-Profit Organization $134 Real Estate Broker / Member $99 Friend Member $95 Note: Owners of more than one business pay 50% for each additional membership. Real estate brokers working for a member real estate firm pay 50% or $99/year for a separate business listing. Membership Level * 1-10 Employees $199 Associated Member 1/2 off 2nd Membership $99 11-25 Employees $259 26-150 Employees $359 Over 150 Employees $559 Bank or Utility $559 Associated Member 1/2 off 2nd B/U Membership $279.50 Real Estate Broker / Member Firm $99 Non-Profit Organization $134 Associated NP Member 1/2 off 2nd Membership $67 Friend Member $95 Complementary/Exchange of Services - $0 (Select Your Membership Level) Associated Membership Business Name For 1/2 price Associated membership, what is the name of the Business that pays full price? I understand that my annual membership will automatically renew each year unless I send the Chamber a written resignation thirty days in advance of the expiration of any current annual term. Yes Total Dues Please send me an invoice Yes If you need an invoice, we will email you an invoice. Pay Member Dues by Check (Click Title to Open) I prefer to pay my Chamber Member Dues by check. Yes Make Checks Payable to Carolina Foothills Chamber of Commerce and mail it to: Carolina Foothills Chamber of Commerce 2753 Lynn Road Suite A Tryon NC 28782 Clicking the "Submit" button below will submit your membership application and will automatically take you to Paypal. If you plan to pay by Check, click the "Submit" button below and simply close your web browser once you get to PayPal. Pay Member Dues by Credit, Debit, or PayPal (Click Title to Open) I prefer to pay my Member Dues by Credit, Debit, or PayPal. Yes PAYMENT OPTIONS: USE YOUR EXISTING PAYPAL ACCOUNT - Click the "Submit" button below, then enter your existing PayPal account username and password and click the "Log In" button or PAY WITH A MAJOR DEBIT / CREDIT CARD - click the "Submit" button below, then click the "Pay with Debit or Credit Card" button at the bottom of the form. Membership Admin Only Captcha If you are human, leave this field blank.