Member Application

Thank you for your interest in becoming a member of the Somerset Area Chamber of Commerce! All completed membership applications will be forwarded to our staff for review and processing. Upon completion we will contact you via email with information allowing you to begin accessing your benefits 24/7 through our online Member Information Center (MIC). Also, as you're choosing which level of membership applies to you, keep in mind that our membership dues are currently based off of the number of FT & PT employees your company/organization has: 1) Two (2) PT employees = 1 FT employee; 2) PT employees are counted as those who work <20 hours/week, including paid interns, and any temporary or seasonal workers that are paid cash or in-kind.

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:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

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:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Print Application