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Name of Firm/Company
*
Name of Contact Person:
*
Title/Position in Firm/Company:
Telephone Number (###-###-####):
*
FAX Number (###-###-####):
Email Address
Web Site Address
Mailing Address:
*
City
*
State
Zip Code
*
Type of Business
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Accountants
Advertising
Architechs
Attorneys
Automotive
Banking
Beauty Salon
Boutique
Business
Business Consulting
Catering
Chiropractor
Clothing
Communications
Community
Computer Services
Dental
Dining
Education
Financial
Florist
Food & Entertainment
Gifts and Incentives
Government
Healthcare
Household & personal
Insurance
Jewelry & Coins
Marina
Marketing
Martial Arts
Medical
Museum
Pet care
Plumbing and Heating
Printing
Real Estate
Religious
Senior Living
Shopping
Swimming pool services
Trades
Travel Services
OTHER
Description
Number of Persons in Firm/Company
*
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-- Please choose a business size --
Individual (Non-Business Member) $95.00
Business - 1 Employee $125.00
Business - 2 to 5 Employees $195.00
Business - 6 to 10 Employees $295.00
Business - 11 to 35 Employees $395.00
Business - 36 to 100 Employees $595.00
Business - Over 100 Employees $895.00
Not-For-Profit & Educational $150.00
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An asterisk(*) denotes required information.