Chamber Application

New Member Application

Company Information
Company:
*
Address Line 1:
*
Address Line 2:
City:
*
State:
*
Zip:
*
Phone 1:
*
Phone 2:
Fax:
E-mail:
*
Website:
Bus. Category 1:
Bus. Category 2:
Bus. Category 3:
Established Date:
Full-time Employees:
*
Part-time Employees:
*
Business Description:
Character Limit: 0/500
Create Member Account Login
Your member account allows you to update your information online via a secure login.
Admin E-mail:
*
Password:
*
Verify Password:
*
Contacts
Primary Contact
Prefix:
First Name:
*
Last Name:
*
Suffix:
Familiar Name:
Title:
Create Login
Your member login allows you to update your information online and register for events.
Username:
*
Password:
*
Verfiy Password:
*
 
Billing Contact
 
Membership Investment Rates
Billing Frequency:
By choosing the monthly payment option, I understand that I am entering into a 1-year partnership with the chamber and agree to pay all monthly dues invoices. After completing the 1-year partnership, I understand that my membership will renew automatically unless the chamber is given 30-day notice to terminate partnership.
# Employees
Annual Dues
1-15
$220.00
16-49
$385.00
50+
$690.00
1-15
$20.00
16-49
$35.00
50+
$65.00
$220.00
$690.00
Must send chamber a copy of 501(c)3
$155.00
This level of membership is designed for an individual who has withdrawn from or are not active in employment (i.e. retiree)
$75.00
Total:
$0.00
Security Code:
Please enter the security code above.
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321 Main Street Irwin, PA 15642

 

724-863-0888

info@norwinchamber.com

321 Main Street Irwin, PA 15642

724-863-0888

info@norwinchamber.com