Title

Member Application
Business Information

Company Name: *

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Phone: *

Website: *

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

Interested in becoming a Volunteer:

Interested in Sponsoring an Event?:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

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Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

Facebook Twitter Instagram

Address

Same as Member Address

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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

Login: *

Password: *

Social Networking:

Facebook Twitter Instagram

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

INDIVIDUAL: $50.00
Single or personal membership COMMUNITY : $150.00
Civic organizations, churches, clubs & non-profit's BASIC: $200.00
Retail, health care facilities, insurance, media, restaurants & places to stay with 0 - 20 Employees BUSINESS : $300.00
Attorney's, physicians, real estate firms, accountants, retail, health care facilities, media, restaurants & places to stay with 21-50 Employees Industry & manufacturing with 0-20 Employees Small utility groups with 0-10 Employees PROFESSIONAL: $400.00
Retail, health care facilities, media, restaurants & places to stay with 51-100 Employees Industry & manufacturing with 21-50 Employees PARTNER: $500.00
Health care facilities & hospitals with 101+ Employees Industry & manufacturing with 51-100 Employees VIP: $600.00
Retail, media, restaurants & places to stay with 101+ Employees Industry & manufacturing with 101+ Employees ELITE: $1,100.00
Banks & financial institutions INVESTOR: $1,200.00
Utilities with over 10 Employees

Additional Opportunities:

We will contact you with additional information.

REAL ESTATE AGENT _ A : $100.00
Real Estate Agent of a Member Firm REAL ESTATE AGENT _ B : $300.00
Real Estate Agent of a Non-Member Firm ADDITIONAL BUSINESS : $0.00
Sistering or additional membership is half price of membership type ONE - TIME PROCESSING FEE : $25.00
Membership (one time) Sign Up Processing Fee

Payment Option:

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