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. * * * To change login password, please 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. Membership Level * 1-10 Employees $199 11-25 Employees $259 26-150 Employees $359 Over 150 Employees $559 Bank or Utility $559 Associate Member $95 Real Estate Broker / Member Firm $99 Non-Profit Organization $134 Complementary/Exchange of Services - $0 (Select Your Membership Level) 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) 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 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: email@example.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 Billing Info INVESTMENT SCHEDULE 2018 1-10 Employees $199 11-25 Employees $259 26-150 Employees $359 Over 150 Employees $559 Bank or Utility $559 Associate Member $95 Non-Profit Organization $134 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. Billing Address Billing City Billing State Billing Zip Billing Phone Billing Email Social Media (CLICK THE TITLE ABOVE TO OPEN THIS SECTION) LinkedIn URL Google+ URL Facebook URL Twitter URL Membership Admin Only (ADMIN ONLY) Captcha If you are human, leave this field blank.