Membership Application

The North Rockland Chamber of Commerce welcomes individuals and businesses to become members. Currently we offer three levels of membership.

You have two options. And it doesn’t matter if you’re a startup, small business, not-for-profit, individual, or other.
- $50 per year
- $ 5 per month

Please note if you represent a business you must sign up for a business membership, individual memberships are for residents who are not involved with a business in anyway but wish to keep up to date on happenings or contribute to the organization.

Note: Membership Dues are on a rolling basis. Your payment is good for a 12 month term regardless of when you register.

Registering online will allow you to create your Membership Directory Entry immediately upon payment and you will be automatically added to our mailing lists. If you wish to pay by check, please call our main number and we will get back to you.

Ready to get started? Let’s go! Fill out the form to begin your membership process. On the next page, you will be redirected to the payment page. From there you can choose monthly or annual payment method!

Applicant's Name*
First Last
Business Name*

* For individuals please type in Non-Business
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

* If mailing address is different then the business address. Not listed on member directory
Website Address
Business Phone Number*
Direct Phone Number
* If you would like to give another number that's better to reach you. Not listed on member directory
Business Email*
Membership Type (Please choose one)*
- Starter: $5/mo or $50/yr
- Local: $5/mo or $50/yr
- NFP: $5/mo or $50/yr
- Other: $5/mo or $50/yr
***Please Note: All membership applications are subject to approval by the Board of Directors of the North Rockland Chamber of Commerce.***
For our website directory, what would you like your business description to say? Tell us a little about your business:*
Website Member Directory Image. Do you have a logo you would like us to use for your website directory?*
- Yes
- No
File
Accepted file types: jpg, gif, png, Max. file size: 2 MB.
Please upload your image here. The file size must not exceed 250 kb, and should be in .jpg, .png or .gif format.
What benefits do you expect from the North Rockland Chamber of Commerce?*
In what ways are you interested in being involved with the Chamber?*
Consent
In applying for membership, and by checking the box marked "I agree" below, I agree to conform to the by-laws of the North Rockland Chamber of Commerce.*
- I agree
Name of Applicant*
Date*
CAPTCHA
Note: You will be redirected to the payment page after successfully submitting this form.
Name
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