Membership

"*" indicates required fields

Membership Type*

Chamber of Commerce (Annual Fee - $250)

Civic/Business Organization (Annual Fee - $200)

Not for Profit (Annual Fee - $150)

Membership*

New

Renewal

Members

(How many members does the organization represent)

Organization Information

Organization Name*

Website

First name*

Last name*

Business email*

Contact email

Business phone*

Mobile

Fax

Organization Information

Address*

Billing and Business address are not same

Business Information

Billing Address

The undersigned, if approved, hereby agrees to faithfully uphold the constitution and by-laws of the Suffolk County Alliance of Chambers, Inc. and further the goals and purpose of the organization. It is further understood and agreed that, subject to application approval by the board of directors, I agree to pay the annual dues as long as I remain a member.

Signature*

Credit Card

Membership

Membership

Organization Information

Organization Information

Business Information

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