Testing Membership Application Step 1 of 3 33% CommentsThis field is for validation purposes and should be left unchanged.CONTACT INFORMATIONContact Name(Required) First Last Email Address(Required) Enter Email Confirm Email Business NamePhone(Required)Physical AddressThis information will displayed in the membership directory. Address City ZIP Code WebsiteReferral Source BUSINESS INFORMATIONMember Directory Category(Required)Choose all that apply Attorney Auto & Marine Beauty, Wellness, Sports & Recreation Business Services Community, Local Government & Non-Profit Education & Training Finance & Banking Home & Garden Insurance Lodging Marketing & Photography Media Production & Books Medical & Holistic Health Museums & Art Pet Services Realty & Speciality Senior Services Technology Business HoursSundayMondayTuesdayWednesdayThursdayFridaySaturdayDescription of Business Products & ServicesUpload Business LogoAccepted file types: jpg, png, pdf, Max. file size: 2 MB. Volunteer InterestWould you like to host a Business After Hours event? Yes No Unsure, contact me Do you want to volunteer at special events? Yes No Unsure, contact me Which committees are you interested in? Marketing Membership Community Development Events & Sponsorships Unsure, contact me Consent(Required) I agree, that the information provided in the Chamber Member Registration can be used on the website and consent to receive email notifications. Membership payment(Required) Pay in Full Monthly Auto Draft (only available for 1 Employee or 2-10 Employees membership levels) 1-Year Membership(Required)Please select your membership level below, which is based on the number of employees in the business. 1 Employee $150.00 2-10 Employees $225.00 11-20 Employees $325.00 21-30 Employees $450.00 Over 31 Employees $550.00 Non-Profit Business $125.00 1-Year Membership Monthly Auto Draft(Required)Please select your membership level below, price is the monthly auto draft amount. 1 Employee $18.00 a Month 2-10 Employees $25.00 a Month Total Select Payment(Required) Credit Card Mail or Drop-Off a Check to 110 Mid Atlantic Place, Yorktown, VA 23693 Billing Address(Required) Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Credit Card Δ
