Staff Referral (Optional)

DREW BILL NICK KRISTIN WENDY

Organization *

Business Website

Business Email *

First Name *

Last Name *

Address Line 1 *

City *

State *

Enter required value

Postal Code *

Phone *

Email *

Connect Member Business Types

Choose a Chamber Membership that fits your business.

Connect Small Business (1-5 Employees) $28 per month or $325 per year Connect Medium Business (6-15 Employees)$38 per month or $450 per year Connect Large Business (16-100 Employees) $55 per month or $650 per year Connect Non-Profit Organization ($13 per month or $150 per year)

Elevate Level Membership - $1,000/yr

Payment Frequency *

One Time Annual Payment

Monthly Payments

Bill Me Annually

Credit Card Number

Credit Card Expiration Date

Credit Card CVC

Credit Card Billing Zip Code

Authorization *

I hereby authorize the Crystal Lake Chamber of Commerce to initiate debit/credit entries to my account indicated above in the amounts equal to each membership dues invoice, and I authorize the depository financial institution named above to process said entries. There will be a $20.00 fee charged for any returned payments for any reason, including non-sufficient funds.

This authorization for Monthly Investment Program is to remain in full force and effect until Crystal Lake Chamber of Commerce has received written notification from me of cancellation 30 days prior to the date of payment. By filling in your name in the Authorized Signature box below you certify the accuracy of the information provided in this application and approve the application to be submitted to the Crystal Lake Chamber of Commerce for processing.

Chamber Staff Referral

Did a Chamber staff member help you in joining the Chamber?

DREW KRISTIN WENDY NICK

Member Referral

Did an existing member refer you to the Chamber?