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Greater Derry Londonderry Chamber of Commerce

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Member Application

Business Information

Company Name: *

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Phone: *

Website:

Email:

Business Description (200 char max):

Directory Category:

Employees: *

Full-time Part-time

Physical Address

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Mailing Address

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Primary Contact Information

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Last Name: *

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Contact Preference:

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Address

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Billing Contact Information

Same as Primary Contact

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Last Name:

Title:

Phone:

Email:

Contact Preference:

Email Phone

Login:

Password:

Address

Same as Member Address

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Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Nonprofit: $199.00
1-2 Employees: $250.00
3-19 Employees: $325.00
20-50 Employees: $425.00
51-99 Employees: $700.00
100+ employees: $850.00
Retired/Job Seeker: $75.00

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