Membership Application

 
   
Organization Information (to be displayed online)
Organization Name *
Address 1 *
Address 2
City *
State *
Zip *
Phone *
Fax
Website
Email *
Main Contact
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Zip *
Title *
Phone *
Email *
Additional Contacts
Mailing Address (if different)
Street
City
State
Zip
Billing Address (if different)
Street
City
State
Zip
Additional Information
For enhanced online visibility, be sure to provide a business description for vtchamber.com.
Membership Investment
Membership Type: *
Primary Directory Category *
Additional Directory Categories
  • Primary Directory listing is complimentary
  • Up to two additional Directory listings are complimentary
  • After two, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories**
  • If your business is a lodging property, choose "LODGING" and enter number of rooms.
  • If your business is a restaurant or bar, choose "DINING".
  • For all other business sectors, membership is based on number of full time employees, (FTE), choose "ALL OTHER BUSINESS SECTORS" and enter number of FTE's.
Number of Full Time Employees:  
Number of Part Time Employees:  
Number of Rooms:  
Number of Rooms (with Public Dining):  
Number of Seats:  
   
$ 
$ 
$ 
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
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
tempValueForDropDown1
Number of Locations ($35/add. location):  
Millions in Assets (Financial Institutions):  
Enhanced Membership ($50):
*
Credit Card Information
Credit Card Type *
Credit Card Number * 
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Please click submit only one time.  The transaction may take several seconds.