Membership
Membership Enrollment Form

Please complete the form below to enroll in AICC

Applicant Information:
* Name:
Company Name:
(if applicable)
* Address:
* City:
* State:
* Zip:
* Phone:
Fax:
* Email:
Please check here if you do not wish to receive email about the chamber.
Website:
Company Profile:
Please indicate your company's business sector by checking the appropriate box below
  Accountin    Accounting    Acounting 
  Agribusiness    Banking    Construction 
  Consulting    Distribution    Economic Development 
  Education    Energy    Executive Recruiting 
  Executive Recruiting/Human Res    Exeutive Recruiting/H.R.    Financial 
  Financial Services    Financial Services; Wealth Mgm    Flowers 
  Food & Beverage    Funeral Services    H.R. 
  Health and Beauty    Import/Export    Information Technology 
  Insurance    International Relations    Investment Banking 
  Jewelry    Law    Life Sciences 
  Management Services    Manufacturing    Marketing 
  Media    Not-For-Profit    Other 
  Packaging    Pharmaceuticals    Private Banking 
  Private Equity    Public Relations    Real Estate 
  Security    Shipping    Sports & Fitness 
  Technology    Telecommunications    Translation 
  Transportation    US-Israel Business Development    Venture Capital 
  Wealth Management    Wholesale Distribution 
Please provide a brief company profile (include specialization within sector checked above):
Membership Support:
Please indicate your membership support
  Trustee's Circle 
  • List up to five individuals, with company contact info
  • Hotlink to member website
  • Banner advertising on AICC website
  • Acknowledgment on AICC website
  • Special recognition in programs and printed materials if desired
 
$5,000 
  Sponsor 
  • List up to five individuals, with company contact info
  • Hotlink to member website
  • Banner advertising on AICC website
 
$1,500 
  Corporate 
  • List four individuals, with company contact info
  • Hotlink to member website
 
$600 
  Commercial 
  • List two individuals, includes company contact info
 
$350 
  Individual 
  • Single individual listing (name and home contact info)
 
$200 
  Young Entrepreneurs Forum (<35) 
  • Single individual listing (name and home contact info)
 
$100 
  Uncheck All 
 
 
Payment Information
Amount to Charge:
Credit Card Type:
Card Number:
Security Code:
Expiration Date: MM/YY
 
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