Member Application The Beloit Area Chamber of Commerce helps its members grow and prosper by enhancing the business climate and quality of life in Beloit and the surrounding area. Step 1: Member Info Step 2: Additional Info Step 3: Primary Contact Step 4: Billing Contact Step 5: Membership Options Step 1: Member Info Company Name * Please add your company name. Leave Blank Phone * Please add your company phone number. Website Email * Please add a valid email. Physical Address Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Mailing Address Same as physical address Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Social Network Addresses LinkedIn Facebook Twitter YouTube Pinterest Instagram GooglePlus Step 2: Additional Info Business Description (400 char max) * Please add your company description. Business Keywords * (enter a space between words) Please add your business keywords. Directory Category Choose... Accountants/Tax Services Advertising Agricultural Air Conditioning/Heating/Plumbing Alzheimer's & Dementia Care Facility Antiques Apartments Appliances Sales & Service Appraisal Arts Attorneys Auctioneers Automobile Dealers Automobile Parts & Supplies Automobile Repairs Bakery Banks Beauty Salons Beer & Ale Distributors Bookkeeping Carpet & Rug Dealers Cellular Telephone Service Child Advocacy Chiropractor Churches Cinema City Offices Civic Services/Clubs Clinics-Medical Clothing-Retail College Commercial Printing Communications Community Computer Networking & Sales Computer Service Computers-Printers Concrete Contractors Concrete Producer Construction Convenience Stores Country Club County Directory County Government Credit Union Dentists Discount Store Doors Economic Development Electric Utility Electrical Electrical & Plumbing Supplies Electronic Equip & Supplies Engineers-Professional Entertainment Excavating Farm Equipment Dealers Farm Equipment Manufacturer Feed Dealers Flooring Floral Fountain Fuel/Gasoline Funeral Homes & Directors Furniture General Contractors Gift Store Granite Counter Tops Greenhouse/Garden Center Grocery Guttering Hardware Hardware/Farm Supplies Hardwood, Laminate and Vinyl floors Health Supplies Home Health Hospice Hospital Hunting/Guided Implement Dealers Individual Insurance Internet Service Investment Services Jewelry/Gifts Lawn & Garden Equipment & Parts Liquor Stores Loans Lodging Lumber Manufacturers Marriage, Family & Individual Therapy Massage Medical EyeCare Medical Facility Micro Brewery Motels Movie Theaters Museum Newspapers Non Profit Animal Sanctuary and Rehabilitation Center Nursing Homes Office Supplies/Equipment Optometrists Outdoor Power Equipment Pain Relief Paint Supplies Parenting Support Payroll & Bookkeeping Pest Control Pharmacy Photography Physical Fitness Physicians Plumbing Pregnancy Services Radio Stations Real Estate Rent-To-Own Rental Restaurants Retail Roofing Senior Living Shoe-Retail Siding Contractors Signs Social Services Soft Tissue Therapy Spa Storage-Household & Commercial Surveying Tax Preparation Technology Telephone Service Tire Dealers/Repair Title Company Title Insurance Tourism Traeger Grills Trailer Sales Transportation Trash Hauling Trust Department Utilities Veterinary Video Service Wall and Floor Tile Wallpaper & Wall Covering Retail Weddings/Reunions Windows Full-time Employees * Please add your number of full-time employees. Part-time Employees * Please add your number of part-time employees. Step 3: Primary Contact First Name * Please add your first name. Last Name * Please add your last name. Title Phone * Please add your phone number. Cell Phone Fax Email * Please add a valid email. Contact Preference Email Phone Address Same as Address in Step 1 Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Create Account This Login is already in use Login * Please add your login username. Password * Please add your login password. Step 4: Billing Contact Same as Primary Contact First Name * Please add your first name. Last Name * Please add your last name. Title Phone * Please add your phone number. Cell Phone Fax Email * Please add a valid email. Contact Preference Email Phone Address Same as Primary Contact Address Address line 1 * Please add your address. Address line 2 Country * Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen Please add your country. City * Please add your City. State * Choose... Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Please add your State. State * Choose... Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Please add your State. State * Please add your State. Postal Code * Please add your Postal Code. Create Account This Login is already in use Login * Please add your login username. Password * Please add your login password. Step 5: Membership Package Please select a Membership Package Apartments, Hotels & Motels $150 Base plus $5 per room or unit. See fee schedule and enter fee here: Please enter your fee. Media, Restaurants, Bars, Retail/Service/Manufacturing/Other $150 Base plus $10 per FT* employee See fee schedule and enter fee here: Please enter your fee. Financial/Banking & Investment Base plus $10 per FT* Employee plus $30 per million deposits** See fee schedule and enter fee here: Please enter your fee. Professional Applies to: accountants, architects, attorneys, doctors, dentists, engineers, financial planners, funeral directors, insurance, real estate, stockbrokers, veterinarians, etc. Base per professional plus $10 per FT employee for each non-professional personnel. See fee schedule and enter fee here: Please enter your fee. Utilities Base plus $0.25 per customer*** See fee schedule and enter fee here: Please enter your fee. Non-Profit Organizations $ 75 Individuals $ 50 The individual membership option is available only to persons with no business affiliation. Additional Fees: Administrative Fee $25 one time One time fee for new & reinstated members. Comments/Questions Payment Option Bill Me Charge my credit or debit card Please complete the Captcha Back Next Submit Application Print Application