Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website: *

Email: *

Business Description (739 char max):

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

Reasons for Joining: *

Business Demographics:

Minority-Owned Business:

Female-Owned Business:

Veteran-Owned Business:

Young Professional-Owned:

Not For Profit:

Government Entity:

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: *

Social Networking:

LinkedIn Facebook Twitter Instagram

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Instagram

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 Instagram

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

1-5 FTE Employees CLASSIC: $360.00
With the Classic membership for 1 -5 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 6-20 FTE Employees CLASSIC: $480.00
With the Classic membership for 6 - 20 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 21-50 FTE Employees CLASSIC: $660.00
With the Classic membership for 21 - 50 Full-Time Equivalent Employees -Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 51-100 FTE Employees CLASSIC : $780.00
With the Classic membership for 51 - 100 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 101 - 200 FTE Employees CLASSIC: $1,000.00
With the Classic membership for 101 - 200 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 201 - 500 FTE Employees CLASSIC: $1,500.00
With the Classic membership for 201 - 500 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. 501 - 1,000 FTE Employees CLASSIC: $2,000.00
With the Classic membership for 501 - 1000 Full-Time Equivalent Employees - Receive access to a lengthy list of benefits, Chamber-Exclusive pricing, services, and opportunities. ELITE Chamber Membership: Please contact us to determine the fee.
Benefits and package value to be discussed and determined on case-by-case review.

Additional Fees:

$20 Application Fee : $20.00
Required

Additional Opportunities:

We will contact you with additional information.

Shop Local 365 Donation : $0.00
Add $1/month to your invoice to support Shop Local 365. The Shop Local 365 campaign is a regional partnership among several teams throughout the five-county region of Greater Peoria. The campaign is dedicated to educating the public on the importance and impact of shopping local 365 days a year. Business PAC of Central Illinois Donation : $0.00
Make a voluntary donation to the premier independent, business-focused political action committee for the Peoria area. A donation equal to 10% of your annual dues will be added to your invoice.

Payment Option:

Charge my credit or debit card

Member Application

Mailing Address

Address

Address