CACC Membership Application

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CACC Membership Application

To ensure you are included in all print materials, your membership form and payment must be received by 2/1/2017.

Click here if you prefer to print the letter from the president, member benefits, member plaque information, and application form to submit via mail. Return payment with the form to:

Canton Area Chamber of Commerce
PO Box 153
Canton, PA 17724
cantonareachamberofcommerce@yahoo.com

CACC Membership Application (upd 2016)

* Indicates required field

Business Name *

Owner/Manager Name *

First

Last

Email *

Phone Number *

Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Website *

Facebook *

Comments/Suggestions *

CONTACT INFORMATION (FOR CHAMBER CORRESPONDENCE)

Contact Person *

First

Last

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Person's Phone Number *

Contact Person's Fax Number *

Contact Person's Email *

Additional Email #1 *

Additional Email #2 *

FEE SCHEDULE - PLEASE CHECK APPLICABLE BOX

Membership Level - Select One *

I would like to purchase a membership plaque for $20. *

Yes No

Payment Method *

Check Online Payment

BUSINESS INFORMATION - PLEASE IDENTIFY YOUR BUSINESS CATEGORY FOR THE WEBSITE LISTING

Business Category *

Arts & Entertainment Auction Automotive/Auto Supply Civic Construction & Home Repair Farming & Farm Supply Financial Government Health/Beauty Legal & Professional Marketing Media Oil/Gas Real Estate Restaurant Retail Religious Transportation Utility Other

Please provide your business category if OTHER is selected in the comment box below.

HOW DO YOU PREFER TO BE CONTACTED

How Do You Prefer to be Contacted? Choose One *

Email Phone Fax

Comments/Suggestions *

Would you like to be on a committee? (Finance, Events, Membership, Promotion)

First Choice *

Second Choice *

Submit Application