Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max):

Directory Category:

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter

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

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Membership: See fee schedule to determine the fee and enter it below.
Chamber member dues are listed on the fee schedule. Non-Profits: See fee schedule to determine the fee and enter it below.
Non-Profits (Please see fee schedule) 25% is already taken off original dues. Banks: Please contact us to determine the fee.
Banking institutions are assessed by a different formula. If using fee schedule, enter fee here:

Additional Opportunities:

We will contact you with additional information.

Online Category Banner : $125.00
A banner ad on one category in the online directory. Ad dimensions are 480 pixels x 60 pixels. $125 per year. Website Sponsor - 6 Months : $600.00
An ad on each internal page of newbedfordchamber.com in the right column under “Our Sponsors” Website Sponsor - 1 Year : $1,000.00
An ad on each internal page of southcoastchamber.com in the right column under “Our Sponsors” Premium Website Advertising Package - 6 Months : $1,500.00
Includes a banner ad on each page of southcoastchamber.com; a rotating banner ad on up to three categories in the online directory; and an ad on the home page Premium Website Advertising Package - 1 Year : $2,500.00
Includes a banner ad on each page of southcoastchamber.com; a rotating banner ad on up to three categories in the online directory; and an ad on the home page

Payment Option:

Bill me Charge my credit or debit card

Monday	9am - 4pm
Tuesday	9am - 4pm
Wendsday	9am - 4pm
Thursday	9am - 4pm
Friday	9am - 4pm
Saturday	Closed
Sunday	Closed

Member Application

Mailing Address

Address

Address