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Member Application:

* Company Name:  
* Phone:  
Website:
* Email:
 
* Physical Address:  
* City/State/ZIP:  
Country:
 
Mailing Address: Same as physical address
City/State/ZIP:
Country:
 
Business Category:
* Employees: Full-time:      Part-time: 
Comments/Questions:
 
 

Primary Contact Information:

* Name (First / Last):  /   
Title:  
* Phone:  
Cell Phone:
* Email:  
Contact Preference: Email  Phone
Login:
Password:
 
Social Networking: LinkedIn:
Facebook:
 
Address: Same as Company Address
City/State/ZIP:
Country:
 
 

Billing Contact Information:
Same as Primary Contact
* Name (First / Last):  /   
Title:  
* Phone:  
Cell Phone:
* Email:  
Contact Preference: Email  Phone
Login:
Password:
 
Social Networking: LinkedIn:
Facebook:
 
Address: Same as Company Address
City/State/ZIP:
Country:
 
 
Membership Package:
Church: $121.00
Non-voting membership for not -for-profit Church, religious group or similar organization
Civic Oganzation: $72.60
Non-voting category for charitable civic organization, clubs and youth groups
School: $363.00
Schools,Universities and Educational Institiutuions
Financial Institution, Utilites & Hospitals: $880.00
All Financial Institutions, Utilities and Hospitals regardless of how many employees.
Sole Proprietorship: $145.20
Business owned and operated by a single individual without partners or employees.
2-7 Employees: $181.50
Business with 2-7 employees
7-12 Employess: $242.00
Business with 7-12 emplooyees
More than 12 Employees: $275.00
Dues for Businesses with more than 12 employees are calculated based on the number of full time equivalents. Join now at $275 and any balance will be invoiced or contact the Chamber Office at 618-344-2884.
Payment Option:
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Collinsville Chamber of Commerce | 221 West Main Street | Collinsville, Illinois | 62234 | 618-344-2884