Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website *

Please add your company website.

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

Province

Postal Code

Step 2:

Additional Info

Business Description (200 char max) *

Please add your company description.

Business Keywords * (enter a space between words)

Please add your business keywords.

Directory Category *

Please select a directory category.

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

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Facebook

Twitter

Perth Chamber Blog

GooglePlus

Instagram

YouTube

Create Account

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

Phone

Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Create Account

Password *

Please add your login password.

Step 5:

Membership Package

Please select a Membership Package

1-2 Employees $ 123

2 part-time makes 1 full-time staff

Not for Profit Organizations & Associations $ 123

3-10 Employees $ 176.49

11-30 Employees $ 236.84

31-50 Employees $ 281.62

51+ Employees $ 381.88

Comments/Questions

Payment Option

Charge my credit or debit card

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