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:

Business Started? : *

Receive chamber emails?: *

Information on Group Insurance? :

Website? :

Glendon Business? :

Physical Address

Line 1: *

Line 2:

City: *

Province: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

Province: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Phone:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

Province: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Non-Profit Rate: $89.00
1-2 Employees: $164.00
3-6 Employees: $314.00
16-50 Employees: $514.00
50+ Employees: $1,014.00
7-15 Employees: $414.00

Payment Option:

Bill me

Member Application

Mailing Address

Address