Untitled Document
Membership Application
Business Name*
Primary Contact Person*
Title
Number of Employees*
Year Established
(Example:2008)
License Number
Business Address*
City*
State*
ZIP*
Mailing Address (if different from above)
City
State
ZIP
Primary Phone Number*
-
-
Secondary Phone Number
-
-
Business Fax Number
-
-
Business Website
Primary Email Address*
Confirm Email Address*
Password (If you want to create an account)
Confirm Password
Please ADD my company to your mailing list
Please LIST my company on your online membership directory
Business Category
Please Select One
Advertising & Media
Agriculture, Fishing & Forestry
Arts, Culture & Entertainment
Automotive & Marine
Business & Professional Services
Cleaning Services
Computers & Telecommunications
Construction Equipment & Contractors
Event Planning
Family, Community & Civic Organizations
Finance & Insurance
Government, Education & Individuals
Health Care
Home & Garden
Lodging & Travel
Manufacturing, Production & Wholesale
Personal Services & Care
Public Utilities & Environment
Real Estate, Moving & Storage
Religious Organizations
Restaurants, Food & Beverages
Shopping & Specialty Retail
Sports & Recreation
Transportation
Business Description (125-Letters Max.)
Please note:
The words in this description are also used in the Member Online
Directory Keyword Search, so concentrate on words potential customers might
use in searching for your business.
Reason for joining the Chamber
Please check which Chamber benefits are most important to your business.
Business Assistance and Advice
Professional Development/Training (Seminars)
Marketing/Advertising Opportunities
Networking/Generating New Business
Directory Listings/Phone Referrals
"Clarion" Newsletter
Member Discounts
Business Advocacy
Community Involvement and Support
Other:
Referred By
Areas of Interest
Please check which group or activities of interest
Ambassadors
Business/Education
Golf Tournament
Citizen of the Year Gala
Employee Appreciation Lucheon
CornFest
Hometown Halloween
Holiday Parade
Other: