Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category:

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

County:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

MBCC Annual Membership (1 - 5 employees): $150.00
This is an annual membership for the Maryland Black Chamber of Commerce for companies with 1 to a maximum of 5 employees. MBCC Annual Membership (6 -10 employees): $250.00
This is an annual membership for the Maryland Black Chamber of Commerce for companies with 6 to a maximum of 10 employees. MBCC Annual Membership (11-20 employees): $350.00
This is an annual membership for the Maryland Black Chamber of Commerce for companies with 11 to a maximum of 20 employees. MBCC Annual Membership (21-30 employees): $450.00
This is an annual membership for the Maryland Black Chamber of Commerce for companies with 21 to a maximum of 30 employees. MBCC Annual Membership (over 30 employees): $750.00
This is an annual membership for the Maryland Black Chamber of Commerce for companies with over 30 employees.

Payment Option:

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Member Application

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