Member Application
Business Information
Company Name:
*
Leave Blank:
Phone:
*
Website:
Email:
*
Business Description (200 char max):
*
Directory Category:
--- Select Primary Category ---
Accountants
Advertising/Promotions
Agriculture
Alterations & Sewing
Antiques/Estate Sales/Consignments
Apartments
Architectural Design & Building
Art Galleries
Arts & Crafts
Assisted Living
Attorneys
Automotive
Banks & Credit Unions
Beauty Salons/Spas
Bed & Breakfast
Books & Stationery
Car Rentals
Carpets & Interiors
Childcare
Childrens Clothing/Toys
Chiropractors
Churches
Cleaning Services
Clothing/Shoes
Commercial Plumbing
Community Organizations
Computer Service/Sales
Construction Management
Consultants
Consumer & Commercial Banking
Contractors
Counseling
Country Clubs
Dance
Dental
Drug & Variety Stores
Dry Cleaners
Education
Elected Officials
Entertainment
Event Planning
Financial & Investment Services
Fishing
Fitness
Florists
Food & Beverage/Catering
Forestry
Funeral & Cremation Services
Gifts & Specialty Items
Government
Graphic Design
Grocery Stores
Hardware
Heating & Cooling
Holistic Health
Home Furnishings
Hospitals & Clinics
Hotels/Motels
Human Resource Services
Insurance
Interior Design
Jewelry
Landscaping
Legal Services
Liquor Store
Mail Services/Shipping
Manufacturing & Production
Marine Charters, Sales & Service
Marketing
Massage Therapy
Medical Supply
Medical, Dental & Nursing Care
Mortgage Banking
Office Furniture & Supplies
Optical Services
Personal Services
Pets
Photographers/Photo Finishing/Framing
Press/Publications/Radio
Printing & Typesetting Services
Property Leasing & Management
Public Relations
Real Estate Services
Resorts
Restaurants
Restaurants & Specialty Dining
Security Services
Shopping Centers
Signs & Banners
Sporting Goods
Storage
Tax Preperation
Taxi
Telecommunications
Title Services
Travel Agencies
Utilities
Veterinarians
Wholesale
Wineries & Wine Specialty Shops
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:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Mailing Address
Same as physical address
Line 1:
Line 2:
City:
State:
Postal Code:
Country:
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Primary Contact Information
First Name:
*
Last Name:
*
Title:
Phone:
*
Cell Phone:
Fax:
Email:
*
Contact Preference:
Email
Phone
Login:
*
Password:
*
Social Networking:
LinkedIn
Facebook
Address
Same as Member Address
Line 1:
*
Line 2
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
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
Address
Same as Member Address
Line 1:
*
Line 2
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Canada
United States
Membership Options
Membership Package:
*
1 Employee (includes self)
:
$125.00
This package is only if the entire organization has one employee, including owner. This usually fits direct sale consultants too.
2-10 Employees
:
$250.00
A total of 2 - 10 employees for this rate. Two part-time employees count as one full-time employee when computing dues.
11-25 Employees
:
$400.00
A total of 11 - 25 employees for this rate. Two part-time employees count as one full-time employee when computing dues.
26-50 Employees
:
$550.00
A total of 26 - 50 employees for this rate.Two part-time employees count as one full-time employee when computing dues.
51-99 Employees
:
$800.00
A total of 51 - 99 employees for this rate.Two part-time employees count as one full-time employee when computing dues.
100+ Employees
:
$1,000.00
A total of 100 or more employees for this rate.Two part-time employees count as one full-time employee when computing dues.
Friends of the Chamber
:
$50.00
Friends of the Chamber are not listed on the Chamber Directory. Friends may come to the luncheon and any other chamber events. Friends are only allowed to bring 1 guest to the monthly luncheon & they need to be a potential Chamber Business member.
Non-Profit Org
:
$100.00
This is for a volunteer based organization with no employees at all.
Churches
:
$100.00
This is for Churches only.
Financial Institurions
:
$500.00
This is for Financial Institutions only.
Utilities
:
$800.00
This is for utility companies only.
Payment Option:
Bill me
Please scroll down to view the entire policy and then click Accept.
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I have read and accept the
privacy policy
of Excelsior Springs Area Chamber of Commerce. I grant Excelsior Springs Area Chamber of Commerce permission to contact me regarding my account, news, updates, and offers.
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