Become a Member

 

Ready to join?
Please complete the form below.  A Chamber representative will contact you within the next 1 to 2 business days to complete the application process.

Still have questions?
Contact Mari Potis or call (570) 342-7711.

 Click here to download a PDF of our membership application.

   
Organization Information (to be displayed online)
Organization Name *
Location Address 1 *
Location Address 2
City *
State *
Zip *
Phone *
Fax
Website
Email *
Main Contact
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Zip *
Title
Phone *
Email *
Additional Contacts
Billing Address (if different)
Street
City
State
Zip
Mailing Address (if different)
Street
City
State
Zip
Additional Information
Referred by
How did you hear about us?
What is your reason for joining?
Which programs are you interested in?
*Check all that apply
Business Training Programs
Cost Saving Benefits
Educational Partnerships/Leadership Training
Networking Opportunities
Sponsorship Opportunities
Advertising Opportunities
Award Programs
Volunteer Opportunities
Workforce Development Opportunities
Other           
Membership Investment
Membership Type: *
Primary Directory Category *
Additional Directory Categories
  • Up to two Directory listings are complimentary
  • After two, additional Directory listings are $120 each
**Hold CTRL on your keyboard to select multiple categories**
Number of Full Time Employees:  
Number of Part Time Employees:  
Featured Directory Listing ($250/year):
Highlighted Directory Listing ($125/year):
   
$ 
Total: $ 

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
additionalItem2Cost
Annual Dues (charged to card)
tempValueForDropDown1
*
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
Credit Card Type *
 Credit Card Number              
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Please click submit only one time.  The transaction may take several seconds.