Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (1500 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Carbondale Chamber Gift Certificate Program:

Referred By:

Posse (Ambassador/Volunteer):

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

Login: *

Password: *

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

Login: *

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Additional Opportunities:

We will contact you with additional information.

Extra Categories : $10.00
Each category over your allotted 2 will be an extra $10.00 First Friday Support : $25.00
First Friday Doesn’t Just Happen. Did you know that First Friday is coordinated by a committee within the Carbondale Chamber, and operates on a separate budget? The average monthly cost per First Friday event is $1,000, which includes marketing, advertising, and promotion of the event, resulting in sales tax revenue. We need your help to contribute to “make it happen.” To assist in the continuing success of First Friday, please consider making a donation. Businesses or individuals who contribute $250 or more will receive business logo/name recognition on our website and First Friday eCommunications. First Friday Support : $50.00
First Friday Doesn’t Just Happen. Did you know that First Friday is coordinated by a committee within the Carbondale Chamber, and operates on a separate budget? The average monthly cost per First Friday event is $1,000, which includes marketing, advertising, and promotion of the event, resulting in sales tax revenue. We need your help to contribute to “make it happen.” To assist in the continuing success of First Friday, please consider making a donation. Businesses or individuals who contribute $250 or more will receive business logo/name recognition on our website and First Friday eCommunications. First Friday Support : $100.00
First Friday Doesn’t Just Happen. Did you know that First Friday is coordinated by a committee within the Carbondale Chamber, and operates on a separate budget? The average monthly cost per First Friday event is $1,000, which includes marketing, advertising, and promotion of the event, resulting in sales tax revenue. We need your help to contribute to “make it happen.” To assist in the continuing success of First Friday, please consider making a donation. Businesses or individuals who contribute $250 or more will receive business logo/name recognition on our website and First Friday eCommunications. First Friday Support : $250.00
Receive business logo/name recognition on website and First Friday eCommunications. First Friday Support : $500.00
Receive business logo/name recognition on website and First Friday eCommunications.

Payment Option:

Charge my credit or debit card

Member Application

Mailing Address

Address

Address