Lancaster Area Chamber of Commerce

Lancaster, New York 14086

Building a Better
Business Community

Membership Application

Please fill out the form below completely, or click here to download a printable version of the application.
download a printable version

2010 Membership Dues:

Required fields *

New Business	$99
0 - 5 employees	$150
6 - 10 employees	$190
11 - 20 employees	$220
21 - 30 employees	$250
31 - 50 employees	$310
51 - 100 employees	$380
101 - 500 employees	$495
501 or more	$600

New businesses verifiably less than 6 months old, pay only $99.00 for your first year’s dues. Charitable 501(c)3 Organizations ... $150. Ask about multiple business rates

Business Name: *

Date Business Opened:

Mailing Address: *

Legal Entity Status: *

Street Address:

Contact Person: *

Title: *

Additional Contact Person:

Title:

Phone: *

Fax:

E-mail: *

Cellular Phone/Pager:

Web Site URL:

Discount to Chamber Members:

Number of Employees:

Full Time:

Part Time:

Category Listing for Member Directory:

Additional Categories $10 each:

Briefly Describe Your Business:

I'd like to serve on this committee:

Government Affairs	Education	Membership
Economic Development	Office Help	Marketing

Please Send Information About:

Group Health Insurance

Group Dental Insurance

I'd like to make an additional donation to the Lancaster Area Chamber CARE / GAIT Scholarship Fund:

Yes

Amount:

* Verification Code:

Please enter the characters in the image below:
Verify Code

Lancaster Area Chamber of Commerce
P.O. Box 284 - 41 Central Avenue
Lancaster, NY 14086
E-mail: info@laccny.org
Phone: (716) 681-9755 - Fax: (716) 684-3385

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