Member Application Thank you for your interest! Please complete the following member information. Business Information Company Name: * Leave Blank: Phone: * Website: Email: * Business Description (200 char max): Directory Category: --- Select Primary Category --- Accounting Advertising and Media Arts, Culture and Entertainment Automotive Automotive and Marine Automotive Repair Banks Business and Professional Services Catering Computers and Technology Computers and Telecommunications Construction Equipment and Contractors Credit Union Dental Diagnostics Disc Jockey Elementary Education Finance and Insurance Financial Planning Fitness, Sports and Recreation Funeral Services Furniture Government, Education and Individuals Grocery Store Health and Wellness Health Care Heating and Cooling Home and Garden Hospital Instruction Insurance Interior Design Investing Jewelry Legal Library Lodging and Travel Manufacturing, Production and Wholesale Non-Profit Organization Optometrists Orthodontics Personal Chef Personal Services and Care Personal Training Pets and Veterinary Photography Post Secondary Education Printers Public Utilities and Environment Real Estate, Moving and Storage Religious Organizations Resale Consignment Restaurants, Food and Beverages Restoration Sales and Service Service Organization Shopping and Specialty Retail Tanning Salon Transportation Employees: * Full-time Part-time Comments / Questions: Referred by: Non profit: Yes No 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 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 South Sudan 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 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 South Sudan 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 Social Networking: LinkedIn Facebook Primary Contact Information First Name: * Last Name: * Title: Phone: * Email: Contact Preference: Email Phone Login: Password: Social Networking: LinkedIn Facebook Billing Contact Information Same as Primary Contact First Name: Last Name: Title: Phone: Email: Contact Preference: Email Phone Login: Password: Social Networking: LinkedIn Facebook Membership Options Membership Package: * 1-5 Employees: $260.00 6 - 10 Employees: $310.00 11-15 Employees: $390.00 16 - 20 Employees: $470.00 21-50 Employees: $620.00 51-100 Employees: $780.00 101 + Employees: $880.00 Not for Profits: $100.00 Weblink is included at no additional charge for Not for Profits. Associate Member: $100.00 My company is already a member and I would like to join as an additional representative. Please add me to the email list and to the membership directory. 2 Part Time Employees = 1 Full TIme Employee: Additional Opportunities: We will contact you with additional information. Weblink - $ 30.00 : $30.00 Link your business website to MunsterChamber.org. Make it even easier to be found! Prepaid Membership Lunches - $ 250.00 : $250.00 Prepay for your monthly membership luncheons. One lunch per month for 12 consecutive months. Pay for 10 and get 2 months free! Payment Option: Bill me Charge my credit or debit card Please scroll down to view the entire policy and then click Accept. Decline I have read and accept the privacy policy of Munster Chamber of Commerce. I grant Munster Chamber of Commerce permission to contact me regarding my account, news, updates, and offers. Please read and accept the privacy policy before continuing. Print Application