Membership Application Thank you for your interest in joining the chamber. Please fill out the following form as completely as possible. If you have 500 or more employees, contact the chamber at (207) 623-4559 for investment information. Membership dues may be tax-deductible as an ordinary and necessary business expense but are not a charitable deduction for federal tax purposes. Company(*) Invalid Input Location Address(*) Invalid Input Mailing Address (if different than Location Address) Invalid Input Company Phone(*) Invalid Input Facebook Invalid Input Company Email(*) Invalid Input Twitter Invalid Input Website Invalid Input Instagram Invalid Input Brief Description Invalid Input Company Category(*) Accountant Airlines & Aviation Associations and Interest Groups Attorneys & Legal Services Automotive Car Wash Automotive Parts and Services Automotive Repair Automotive Sales and Repair Boat Sales/Marine Services Business Services Campgrounds Childcare Cleaning Services Computer Support & Software Services Construction Services Consultants Custom Apparel Dance Studios Dentists & Orthodontists Distributors Dry Cleaners Education Employment Services Engineers/Surveyors Entrepreneur Event Services Eyecare Services Financial Advisors Financial Institutions Fitness & Health Florists & Garden Centers Fuel Delivery Funeral Services Government Government Affairs Grocery Hair Care/Salons/Spas/Skincare Healthcare Services Healthcare Services/Nonprofit Insurance Landscaping Lodging in Kennebec Valley Lodging Outside of Kennebec Valley Manufacturers & Processing Marketing and Design Museums/Arts & Culture Non-Profit Office Equipment Pest Control Photography Printers and Publishers Professional Services Radio and Television Real Estate Recreation & Amusement Restaurants Retail Security Services Shopping Centers Towing Services Transportation Travel Agencies Utilities Veterinarians & Animal Care Waste Cleanup Website / Graphic Design Invalid Input Shop Local Program Would you like to be enrolled in our Shop Local Program? Participate in Shop Local(*) Enroll Me Opt-Out of the Program Invalid Input Investment Schedule Please make the appropriate selection below. A 2 year membership will save you 15%. Investment Schedule Sole Proprietor - 212.00 USDSole Proprietor 2 Year Membership - 361.00 USD2-4 Employees - 235.00 USD2-4 Employees 2 Year Membership - 399.00 USD5-9 Employees - 313.00 USD5-9 Employees 2 Year Membership - 532.00 USD10-19 Employees - 392.00 USD10-19 Employees 2 Year Membership - 667.00 USD20 - 29 Employees - 470.00 USD20 - 29 Employees 2 Year Membership - 798.00 USD30 - 39 Employees - 551.00 USD30 - 39 Employees 2 Year Membership - 937.00 USD40 - 49 Employees - 628.00 USD40 - 49 Employees 2 Year Membership - 1,068.00 USD50 - 74 Employees - 707.00 USD50 - 74 Employees 2 Year Membership - 1,201.00 USD75 - 99 Employees - 783.00 USD75 - 99 Employees 2 Year Membership - 1,331.00 USD100 - 124 Employees - 863.00 USD100 - 124 Employees 2 Year Membership - 1,467.00 USD125 - 149 Employees - 940.00 USD125 - 149 Employees 2 Year Membership - 1,599.00 USD150 - 174 Employees - 1,018.00 USD150 - 174 Employees 2 Year Membership - 1,730.00 USD175 - 199 Employees - 1,097.00 USD175 - 199 Employees 2 Year Membership - 1,865.00 USD200 – 224 Employees - 1,175.00 USD200 – 224 Employees 2 Year Membership - 1,998.00 USD225 - 249 Employees - 1,251.00 USD225 - 249 Employees 2 Year Membership - 2,127.00 USD250 - 274 Employees - 1,334.00 USD250 - 274 Employees 2 Year Membership - 2,268.00 USD275 - 299 Employees - 1,410.00 USD275 - 299 Employees 2 Year Membership - 2,397.00 USD300 - 324 Employees - 1,487.00 USD300 - 324 Employees 2 Year Membership - 2,528.00 USD325 - 349 Employees - 1,567.00 USD325 - 349 Employees 2 Year Membership - 2,663.00 USD350 - 374 Employees - 1,647.00 USD350 - 374 Employees 2 Year Membership - 2,800.00 USD375 - 399 Employees - 1,723.00 USD375 - 399 Employees 2 Year Membership - 2,929.00 USD400 - 424 Employees - 1,801.00 USD400 - 424 Employees 2 Year Membership - 3,062.00 USD425 - 449 Employees - 1,880.00 USD425 - 449 Employees 2 Year Membership - 3,196.00 USD450 - 474 Employees - 1,957.00 USD450 - 474 Employees 2 Year Membership - 3,327.00 USD475 - 499 Employees - 2,036.00 USD475 - 499 Employees 2 Year Membership - 3,462.00 USD Invalid Input Total Investment 0.00 USD Credit Card Information Please enter your credit card information below. First Name Invalid Input Last Name Invalid Input Company Name Invalid Input Address Invalid Input City Invalid Input State AKALARAZCACOCTDEFLGAHIIAIDILIN KS KY LA MA MEMD MI MNMOMSMTNCNDNENHNJ NMNVNYOHOKORPA RISCSDTNTX UTVAVTWAWDCWIWVWY Invalid Input Zip Code Invalid Input Credit Card # Invalid Input Exp Month 010203040506070809101112 Invalid Input Exp Year 2020202120222023202420252026202720282029203020312032203320342035 Invalid Input CVV Number Invalid Input Authorize.net Contact Information Main Contact Name(*) Invalid Input Main Contact Phone(*) Invalid Input Main Contact Email(*) Invalid Input Billing Contact Name(*) Invalid Input Billing Address (if different than Mailing Address) Invalid Input Billing Contact Email(*) Invalid Input Marketing Contact Name Invalid Input Marketing Contact Email Invalid Input Please check the box to verify you are human.(*) Invalid Input
