Join Us - Greater Lehigh Valley Chamber of Commerce

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Organization Information
Company Name:
Primary Contact First Name:*
Primary Contact Last Name: *
eMail: *
Address Line 1:
Address Line 2:
Address Line 3:
City / Borough / Township:
Additional Contacts
Additional Information
Facebook Page URL:
Twitter URL:
Referred By:
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My business is (check all that apply):

Please list all of your interests

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Membership Investment
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Primary Directory Category *
Number of Full Time Employees:  
Number of Part Time Employees:  
Total: $ 

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Full-Time Employees
Part-Time Employees
Annual Dues (charged to card)
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information
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Credit Card Address 1
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