Member Application

Thank you for your interest in the Cuyahoga Valley Chamber of Commerce.

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:

Volunteer Opps:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook

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:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

1-10 Employees: $150.00
11-25 Employees: $200.00
26-50 Employees: $275.00
51+ Employees: $325.00
Non-Profit Membership: $150.00

Additional Opportunities:

We will contact you with additional information.

Member List : $35.00
Excel File of Current Members

Payment Option:

Bill me Charge my credit or debit card

Print Application