Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Twitter

Instagram

YouTube

Yelp

TikTok

Open Table

Grubhub

Houzz

Google My Business

AVVO

Vimeo

Justia Lawyers

DoorDash

Uber Eats

Indeed

Untappd

Book Appointment

Step 2:

Additional Info

Business Description (200 char max)

Business Keywords (enter a space between words)

Directory Category

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

Billing Preferences (Choose One)

Print or Email *

Looks good!

Company Owner Information

President/Owner Name *

Looks good!

President/Owner Email Address *

Looks good!

Company HR Information

HR Representative Name (If Applicable)

HR Representative Email (If Applicable)

Analytics Information

How did you hear about us? *

Looks good!

Who refered you?

Is your company owned, operated, or controlled 51% or more by an individual that meets any of the following?

Select a Option

Chamber Programs of Interest

Select a Program

Additional Programs

Committees & Councils of Interest

Select a Committee or Council

Additional Committees & Councils

Chamber Annual Events of Interest

Select a Event

Additional Events

Ribbon Cutting Information

Would you like to have a ribbon cutting ceremony? *

Looks good!

Chamber Advertising

Would you like to be contacted about website advertising? If so please check the box.

Chamber Insurance Program (You must have a min of 3 employees)

Would you like to know more information about our insurance discount program? If so please check the box.

Full time employees count for insurance program only?

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Fax

Contact Preference

Phone

Address

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password

Step 5:

Membership Package

Please select a Membership Package

Basic Membership $220

Basic Membership **Please Note** All memberships subject to an employee factor of $5.00 per full time employee over 5. This amount will be invoiced to your company upon acceptance of your application.

Basic Membership-Semi Annual $110

Pay your membership in 2 installments **Please Note** All memberships subject to an employee factor of $5.00 per full time employee over 5. This amount will be invoiced to your company upon acceptance of your application.

Non Profit Membership $200

Non Profit Membership **Please Note** All memberships subject to an employee factor of $5.00 per full time employee over 5. This amount will be invoiced to your company upon acceptance of your application.

Non Profit Membership-Semi Annual $100

Banks, Credit Unions Please contact us to determine the fee.

Killingworth Businesses Please contact us to determine the fee.

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Create Account

Step 5:

Membership Package

Payment Option

The Sun Always Shines in Middlesex County!