Membership Application Business InformationI/We formally request membership with the Hardin County Chamber of Commerce. Information below is for official records and other promotional uses.Please Choose Listing Type* Standard Listing (Standard directory included business name and contact information) Enhanced Listing (Receives additional information on business, map, photo gallery and video embed - $100) Name of Member (Organization or Individual)* Business Phone Number*Business Email* Business FaxMobile/Alternate PhoneBusiness WebsitePlease link your website here. Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code We have a different billing address Alternate Billing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Billing Representative (optional) First Last Billing Representative Email Billing Representative PhoneEmployees: Full-TimeEmployees: Part-TimeAbout Your Business*A quick description of your services offered. This will serve as your intro for the next Chamber Luncheon as well!Business Type (Category)*[ Hold CTRL (CMD on Mac) to select multiple entries ]Advertising & MediaAgricultureArts,Culture, & EntertainmentAutomotive & MarineBusiness & Professional ServicesConstruction & ContractorsFinanceGovernment, Education & IndividualsHealth CareInsuranceLegalLodging & TravelManufacturing, Production & WholesaleNon-Profits & Faith-Based OrganizationsPersonal Services & CarePresident's Circle, Community Leader, Community PartnerPublic Utilities & EnvironmentReal Estate, Moving & StorageRestaurants, Food & BeveragesShopping & Specialty RetailTransportationYour LogoAccepted file types: jpg, jpeg, png, gif, Max. file size: 50 MB.Upload your business logo hereDo you have other images of your business? Add Images Here (up to 6 - Enhanced Only) Drop files here or Select files Accepted file types: jpg, jpeg, png, gif, Max. file size: 50 MB, Max. files: 6. Link to embed video (Enhanced Only)If you'd like to embed a video, please paste the full link here. Key Representatives InformationWill you have 1 or 2 Key Representatives?* 1 2 First Last Key Representative Key Rep Email* Name First Last Title Email* Contacted By Membership OptionsPayment Option* Invoice Me Hardin Chamber will send an initial invoice that can be paid via check or credit card online hereCAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Δ
