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 Antiques/Estate Sales/Consignments Apartments Architectural Design & Building Art Galleries Arts & Crafts Assisted Living Attorneys Automotive Banks & Credit Unions Beauty Salons/Spas Books & Stationery Car Rentals Carpets & Interiors Childcare Childrens Clothing/Toys Chiropractors Churches Cleaning Services Clothing/Shoes Community Organizations Computer Service/Sales Construction Management Consultants 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 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 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 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 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 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: * Associate Investment: $85.00 Non- Profits, Individuals, Farm & Ranch Public Investment: $380.00 Local, State, and Federal Agencies Schools, Hospitals Financial Institutions: $945.00 Banks, Credit Unions * Plus $ 24.00/ one million in deposits Utilites Investment: $890.00 Electric, Natural Gas, Telephone/Telecommunications Entrepreneurial Investment: $115.00 Home - based Bed & Breakfasts, Outfitters & Gides Hospitality Investment: $320.00 Hotels/ Motels * Plus $5.20/room Business Investment: See fee schedule to determine the fee and enter it below. 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