Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Step 2:

Additional Info

Business Description

Business Keywords (enter a space between words)

Directory Category *

Please select a directory category.

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Facebook

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

Create Account

Password *

Please add your login password.

Step 5:

Membership Package

Please select a Membership Package

Peoria Area Chamber of Commerce Annual Dues

Please enter the dues amount from the fee schedule matching you employee count group and membership level desired. (*Note: Total of full-time or full-time equivalent (two part-time employees = one full time equivalent)) See fee schedule and enter fee here:

Please enter your fee.

Additional Fees:

$20 Application Fee $20.00

Required

Additional Options:

Business PAC of Central Illinois Donation

Make a voluntary donation to the premier independent, business-focused political action committee for the Peoria area. Suggested donation is 10% of Chamber dues.

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Social Network Addresses

Create Account

Step 5:

Membership Package

Additional Fees:

Additional Options:

Payment Option

Peoria Area Chamber of Commerce

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