Member - Events

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:

Join Reason: *

Receive Invoice Via: *

Payment Options: *

Physical Address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

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:

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: *

Title: *

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: *

Fee Schedule: See fee schedule to determine the fee and enter it below.
Business: Retail/Wholesale/Manufacturing/Restaurants: $285.00 plus $2.50 per full-time employee and $1.25 per part-time employee. Nonprofit/Charitable Organizations: $285.00 Banks/Financial Institutions: $285.00 plus $21.00 for each million of assets up to $100 million. $16.00 for each million over $100 million. (Assets in Lycoming County only. Minimum membership dues of $750.00.) Hotel/Motel: $285.00 plus $4.00 per room. Government Agencies: $285.00 plus $1.00 per full-time employee and $0.50 per part-time. Utilities: $1,025.00 plus additional fee determined upon service area. Minimum membership dues of $1,000.00. Newspapers: $285.00 plus the average daily circulation multiplied by 0.03675. Please contact the Chamber offices at (570) 320-4209 or (570) 326-1971 if you have any questions. Your membership fees may be deductible as a business expense. To settle your dues monthly select the “Bill me” option below. If using fee schedule, enter fee here:

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address