Member Application 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 Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Türkiye Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World 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 Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Türkiye Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World 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 Facebook Twitter Instagram Step 2: Additional Info Business Description (200 char max) * Please add your company description. Business Keywords (enter a space between words) Directory Category * Choose... Accountants Advertising Aircraft Antiques & Collectibles Apartments Architects Artist Attractions Automotive Banks/Credit Unions Bar Tending Services Barbershop Beauty Salons Bowling Brewery Business Services Cable Television Carpet Cleaning Casinos Catering Chiropractors Churches Clothing Colleges/Universities Computers Construction Consumer Goods Cookie Bakery Copiers/Printers Counseling Credit Card Merchant Processing Dentists Department Stores DJ Services Dog Grooming & Boarding Education Electrical Contractors Employment Energy Savers Engineering Farm Supplies Fence Construction Financial Services & Advisors Food Vendor Frozen Yogurt Funeral Homes Garage Doors Government Graphic Design/Printing Greenhouse & Garden Center Grocery Stores Health & Fitness Hearing Aids Heating & Air Conditioning Home Improvement Hospice Services Hotels/Motels Human Resources HVAC Controls - Installation & Service Insulation Contractors Insurance Internet Investments Jewelry Laboratory Lawn & Landscaping Lawnmower Repair Legal Services Library Liquor Stores Manufacturing Massage Therapy Military Mortgage Companies Movie Theatres Music Nail Salons Newspapers Non-Profit Nutrition & Wellness Office Supplies Organizations Paint Pest Control Pet Supplies Pharmacy Phone Company Photography Physical/Occupational Therapy Physicians/Medical Picture Framing Plumbing Pool & Spas Power Washing Pre-Schools Promotional Products Publishing Purses/Hand Bags Radio/TV Real Estate Real Estate - Commercial Recreation Center Rental-Party Supplies & Equipment Rentals & Storage-Industrial/Commercial/Construction Restaurants/Specialty Foods Restoration Companies Retail-Specialty Retirement/Assisted Living Schools/Private Schools/Public Security Systems Senior Living Shipping/Mailing Skilled Nursing & Rehabilitation Skin Care/Cosmetics/Nutrition Sports Sports Tax Preparation Telecommmunications Title Companies Trash Hauling Travel Agencies Utilities Veterinary Clinics Vision Care Please select a directory category. 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 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 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 Annual Chamber Membership - Paid in Full $ 350 annually Switch to monthly autopay? Derby Chamber of Commerce membership for one year. Annual Chamber Membership - Paid Monthly $ 32 annually Switch to monthly autopay? Derby Chamber of Commerce membership paid in $30 monthly installments with a credit/debit card or checking account. Additional Options: New Resident Welcome Bag Insert $125 one time Every new resident that moves to the City of Derby receives a Derby Chamber of Commerce welcome bag. This add-on will allow you to place any promotional item of your choice in each welcome bag for one year. This is a great way to market your business to approximately 1,000 new residents each year! Additional Location $125 one time Additional locations may be added to an annual membership at a reduced rate of $125, allowing the marketing of other locations. Businesses with second locations or branch offices must share common ownership and business category. McConnell Action Group $50 one time McConnell Action Group (MAG) is a community program that helps support men, women and families of McConnell Air Force Base. MAG membership gives you access to exclusive invitations to McConnell Air Force Base events, tours and ceremonies. Chamber Ambassador Group Becoming a Chamber Ambassador is an excellent way to market your business and network among other members. Your increased involvement helps the community connect a face to your business and provides you with added visibility. Chamber Ambassadors receive exclusive invitations to ribbon cuttings and occasional VIP events, are recognized on the Chamber's website and social media accounts and get a personalized Chamber magnetic name tag. Event Sponsorships Please select this add-on if you are interested in sponsoring an event. Chamber staff will get in contact with you about available options! Comments/Questions Payment Option Bill Me Charge my credit or debit card Please complete the Captcha Back Next Submit Application Print Application