Chamber of Business & Industry of Centre County
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Organization Information (to be displayed online) Organization Name Address 1 Address 2 City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Phone Fax Website Email Main Contact Copy from Organization-Information First Name Last Name Address 1 Address 2 City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Title Phone Email Additional Contacts Add/Remove Contacts Contact 1 First Name Last Name Title Email Address Contact 2 First Name Last Name Title Email Address Contact 3 First Name Last Name Title Email Address Contact 4 First Name Last Name Title Email Address Contact 5 First Name Last Name Title Email Address Contact 6 First Name Last Name Title Email Address Contact 7 First Name Last Name Title Email Address Contact 8 First Name Last Name Title Email Address Contact 9 First Name Last Name Title Email Address Contact 10 First Name Last Name Title Email Address Billing Address (if different) Address 1 Address 2 City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Mailing Address (if different) Address 1 Address 2 City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Additional Information Referred By How did you hear about us? What is your reason for joining? Please have someone contact me regarding Business Resources Community Involvement Cost Savings Programs Economic Development Government Relations Networking Training Opportunities Other Membership Investment Membership Type Select one... Fixed Price Price Per Employee Price Per Room Price Per Seat Price Per Associate Price Per Location Price Per Asset Primary Directory Category None Accounting Accounting Services Advertising Air Purification Air Travel Airport Administration Ambulance Service Answering Service Apartments Appraisals Architects & Engineers Art / Music Instruction Assisted Living / Adult Day Care Association Attorneys Auctioneers Audio Visual Auto Accessories Auto Dealer Auto Rentals Auto Repair Automotive Service - Car Wash Bakery Bank / Financial Institution Banquet Facility Bed & Breakfast Brewery / Distilleries Building Materials Bus Companies / Limo Service Business Intelligence/Discovery Business Services Cabinetry Campground Carpet / Upholstery Cleaning Catering / Food Services Cellular / Pagers Cemetery / Memorial Park Chiropractic Churches / Places of Worship Cleaning, Janitorial & Restoration Services Coffee / Beverage Service Commercial / Retail Space Communications Computer Dealer / Services Construction (Home Builders / Land Developers) Consulting Consulting (Analytical Service) Consulting (Business & Management) Consulting (Employee Benefits) Consulting (Environmental) Consulting (Health & Wellness) Consulting (Health Care) Consulting (Human Resources / Employee Benefits) Consulting (Human Resources) Consulting (Hydrogeologic) Consulting (Technology) Contractors (Concrete) Contractors (General) Contractors (Heating / Air Conditioning) Contractors (Heavy Equipment) Contractors (Home Builders / Remodeling) Contractors (Insulation) Contractors (Other) Convention Center Credit Union Dance Instruction / Performance Dentists / Periodontists / Orthodontists Development Distributor Distributor (Plumbing / Heating) Drafting Services Dry Cleaning Economic Development Education Electric Electrical Supplies Embroidery / Sewing Employment Agency Energy Engraving / Awards Entertainment & Amusement Equipment Rental Equipment Service & Repair Event Planning Excavation Executive Searches Financial Planning & Investments Financial Services Fire Protection Funeral Home Gas Gift Certificate Sales Glass Golf Course Government Graphic Design Grocery Store Gymnastics / Dance Health Care Health Care (Hearing) Health Club / Fitness Training Historic Site Home Inspection Hospital Hydrogeologic Consulting Illustrator, Technical Individual Industrial / Manufacturing Insurance Interior Design Landscaping/Nurseries/Lawn Care Laundry Services Legal Services Library Lodging: Hotels, Motels & Lodges Mailing Services Manufacturing (Analytical Service) Marketing/Digital Marketing Consultants Marketing/Marketing Research Massage Media (Online) Media (Print) Media (Radio) Media (Television) Medical Spa Mobile Development Mortgage & Settlement Services Motorcycle Sales & Service Moving & Storage Museum Natural Resource Development Non-Profit / Social & Community Service Office Equipment Office Furniture/Design Oil/Fuel Optical Other Packing & Crating Paint & Wallpaper Payroll Services Pest Control Pet Care & Supplies/Veterinary Service Photography Physical Therapy Physicians/Surgeons Plumbing Printing & Copying Services Property Maintenance Property Management Psychology/Psychiatry Public Relations Public Transportation Real Estate/Development Realtor Refuse/Recycling Rehabilitation Rental Services/Supplies Research and Development Restaurant Retirement Security Systems Security Systems/Locksmith Senior Services Shopping Shopping (Agriculture) Shopping (Amusement) Shopping (Antiques) Shopping (Appliances) Shopping (Art) Shopping (Beauty/Hair) Shopping (Book Store) Shopping (Carpet/Floor Covering) Shopping (Clothing/Apparel) Shopping (Clothing/Jewelry) Shopping (Convenience Store) Shopping (Department Store/Shopping Center) Shopping (Electronics) Shopping (Florist) Shopping (Furniture) Shopping (Hobbies) Shopping (Home Products) Shopping (Housewares) Shopping (Jewelry) Shopping (Online) Shopping (Pools & Spas) Shopping (Sports) Shopping (Toys) Shredding / Records Destruction Signs Silk Screening Software Development Spa Specialty Foods/Gift Baskets Speech Therapy Sports & Recreation Sports Training/Camps Storage Telecommunications Telephone Sales & Service Theatre Tours Training Translation Service Transportation Travel Agency Tree Service/Arborist Trophies/Awards Trucking/Freight Uniforms Vending Video Warehousing Wastewater Treatment Water Company Weather and Climate Services Web Development/Internet Services Wellness Winery Writing Additional Directory Categories Select additional directory categories below by holding the "CTRL" key Secondary categories may be subject to additional fees none Number of Full Time Employees Number of Part Time Employees Number of Rooms Number of Seats Number of Associates Number of Locations Millions in Assets Annual Membership Investment Additional Items Additional Categories Cost One-Time Application Fee Tax Total The contents of this box are for testing purposes. This box will be removed when the form goes live. Full-Time Employees Part-Time Employees Hotel/Motel Rooms Restaurant Seats Additional Associates Additional Associates Cost Additional Locations Additional Locations Cost Assets Assets Cost Additional Categories Number Of Additional Categories Additional Categories Cost Additional Item 1 Cost Additional Item 2 Cost Additional Item 3 Cost Additional Item 4 Cost Additional Item 5 Cost Additional Item 6 Cost Additional Item 7 Cost Additional Item 8 Cost Additional Item 9 Cost Additional Item 10 Cost Annual Dues (charged to card) Revenue Item Tax (charged to card) Fee (charged to card) Temp Value For DropDown 1 Membership Type Additional Item 1 Additional Item 2 Additional Item 3 Additional Item 4 Additional Item 5 Additional Item 6 Additional Item 7 Additional Item 8 Additional Item 9 Additional Item 10 Payment Type Credit Card Check NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks. Credit Card Information Copy from Organization Information Credit Card Type MastercardVisaDiscoverAmex Credit Card Number Name on Card Security Code Valid Through 01 02 03 04 05 06 07 08 09 10 11 12 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Phone Credit Card Email Address Please click submit only one time. The transaction may take several seconds.
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