Lancaster, New York 14086
The Lancaster Area Chamber of Commerce

Building a Better
Business Community

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Membership Application

Please fill out the form below completely, or click here to download a printable version of the application.
download a printable version
Required fields *
Membership Dues:
   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 Info
Business Name: *
Date Business Opened:
Legal Entity Status: *
Address: *
City: *
State: *
Zip: *
Web Site URL:
Number of Employees: Full Time:  
  Part Time:  
Briefly Describe Your Business:
Contact Info
Contact Person: *
Title: *
Additional Contact Person:
Title:
Phone: *
Fax:
E-mail: *
Chamber Listing Info
Category Listing for Member Directory:
Additional Categories $10 each:
I'd like to serve on this committee:  Economic Development
   Education
   Government Affairs
   Marketing
   Membership
   Office Help
Insurance Information
Please Send Information About:   Group Health Insurance
    Group Dental Insurance
Verification & Sending
Verification Code: * Please enter the characters in the image below:
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Lancaster Area Chamber of Commerce
P.O. Box 284 - 11 West Main, Suite 100
Lancaster, NY  14086
E-mail:  info@laccny.org
Phone: (716) 681-9755 - Fax:  (716) 684-3385

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