Join the Canton Regional Chamber of Commerce

1. First Name (Required)
2. Last Name (Required)
3. Email Address (Required)
4. Phone
5. Business Name (as you would like it to appear in the directory) (Required)
6. Business Description (Required)
7. Street Address
8. City (Required)
9. State
10. Zip (Required)

1. Are you participating in or do you plan to participate in the Canton Regional Chamber Health Fund? (Required)

   1. Yes
   2. No
2. Would you like contacted about the Canton Regional Chamber Health Fund? (Required)

   1. Yes
   2. No

1. Key Contact Name (receives all mailing and is listed in the directory) (Required)
2. Key Contact Email (Required)
3. Title
4. Web Address
5. Number of Part-time Employees
6. Number of Full-Time Employees

Would you like contacted before submitting payment?  Leave these items blank and choose "Pay by Mail" option below.  Molly Romig will contact you soon! 

1. Enter 1 to pay your membership fee. ($359.00 ea.)
2. If you have more than 3 full-time employees enter the number (total full-time employees minus 3 that are included) Note: 2 part-time employees = 1 full-time employee ($5.41 ea.)
3. Enter 1 to add your business logo to the online directory. ($35.00 ea.)
4. Upload your business logo