First Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Last Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Title	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Email	Required Please enter a valid number Please enter a valid date Please enter valid credit card information

First Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Last Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Title	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Email	Required Please enter a valid number Please enter a valid date Please enter valid credit card information

First Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Last Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Title	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Email	Required Please enter a valid number Please enter a valid date Please enter valid credit card information

First Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Last Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Title	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Email	Required Please enter a valid number Please enter a valid date Please enter valid credit card information

First Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Last Name	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Title	Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Email	Required Please enter a valid number Please enter a valid date Please enter valid credit card information

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees (Local) Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Part-Time Employees Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Hotel/Motel Rooms Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Restaurant Seats Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Additional Associates Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Additional Associates Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Additional Locations Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Additional Locations Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Assets Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Assets Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information
AdditionalCategories Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Additional Categories Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information
NumberOfAdditionalCategories Required Please enter a valid number Please enter a valid date Please enter valid credit card information
additionalItem1Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

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Annual Dues (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Tax (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information
Fee (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information

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tempValueForDropDown1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Directory Categories Primary Directory listing is complimentary Additional member level based complimentary listing categories: Network Plus: 1 additional category Promotional: Executive: Corporate: Platinum: 4 additional category After the complimentary categories, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories** none
Number of Rooms (Accommodations):
Number of Seats (Restaurants):
Number of Associates (Realtors, Attorneys):
Number of Locations ($35/add. location):
Millions in Assets (Financial Institutions):
Tax	$
Enhanced Membership ($50):
Additional Categories Cost	$
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.