Member Application Congratulations and welcome to the Pataskala Area Chamber of Commerce. Filling out this application is the first step in growing your business! Step 1: Member Info Step 2: Additional Info Step 3: Primary Contact Step 4: Billing Contact Step 5: Membership Options Step 1: Member Info Company Name * Please add your company name. Leave Blank 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 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda 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 Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Mailing Address Same as physical address Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda 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 Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Social Network Addresses LinkedIn Facebook Instagram Twitter YouTube Step 2: Additional Info Business Description (200 char max) * Please add your company description. Directory Category * Choose... Advertising & Media Agriculture, Fishing & Forestry Arts,Culture & Entertainment Automobile & Marine Business & Professional Services Commercial Real Estate Computers & Telecommunications Construction Equipment & Contractors Education Family, Community & Civic Organizations Finance & Insurance Government Health Care Home & Garden Individuals Legal Lodging & Travel Manufacturing, Production & Wholesale Personal Services & Care Pets & Veterinary Real Estate Religious Organizations Restaurants, Food & Beverages Shopping & Specialty Retail Sports & Recreation Storage Takeout/Curbside PU/Delivery/Drive Thru Transportation 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. How did you hear about us? * Looks good! Would you like a Membership Plaque? Answer Yes or No. (Must attend a meeting to receive.) * Looks good! What is your tagline? 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 Email * Please add a valid email. Contact Preference Email Phone Address Same as Address in Step 1 Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda 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 Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Create Account This Login is already in use Login * Please add your login username. 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 Email * Please add a valid email. Contact Preference Email Phone Address Same as Primary Contact Address Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda 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 Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Create Account This Login is already in use Login * Please add your login username. Password * Please add your login password. Step 5: Membership Package Please select a Membership Package Basic Membership $ 175 Website Listing: Company info, Website link, Directions, Hours, Facebook link, About us with contact info Enhanced Marketing Membership $ 300 Enhanced marketing $125 annually + $175 membership = $300 ANNUALLY Priority Placement over Basic listings, Logo/Image next to listing, 200 character description under company name on Search Results, Website link above phone number on Search Results, Expanded description of 1600 characters (standard 200), Bulleted highlights, Additional website links , Slideshow of additional photos or video is available for SEO integrated Chamber sites. Gold Level Membership $ 850 BANNER MARKETING – GOLD LEVEL $675 NNUALLY + $175 MEMBERSHIP = $850 ANNUALLY Top banner advertisement which is shown on all pages, All other available banner ads as available, Map pin upgrade with additional text, web link, photos, All items included in Enhanced listing, 4 opportunities available Silver Level Membership $ 550 BANNER MARKETING – SILVER LEVEL $375 ANNUALLY + $175 MEMBERSHIP = $550 ANNUALLY Specific category banner ads – select your primary and will rotate through others as available. Examples: Business Directory, Events page, in the news page. Select other available ads as available, Map pin upgrade with additional text, web link, photos, All items included in Enhanced listing, 5 primary spots available for each category Bronze Level Membership $ 400 BANNER MARKETING – BRONZE LEVEL $225 ANNUALLY + $175 MEMBERSHIP = $400 ANNUALLY 5 sponsors per category available. Specific category banner in membership business directory and all functions of enhanced level (example – your category only = lodging or restaurant, etc.) Priority placement in business directory, Recognized as chamber website sponsor, Banner ad tracking Comments/Questions Payment Option Bill Me Charge my credit or debit card Please complete the Captcha Back Next Submit Application Print Application