Member

Please complete the form below to apply for membership. Call Tessa at (814) 676-8521 if you have any questions.

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

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.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Twitter

Instagram

YouTube

Website

Step 2:

Additional Info

Business Description

Business Keywords (enter a space between words)

Directory Category

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Step 4:

Membership Package

Please select a Membership Package

Business Membership $ 275

Promoter Membership $ 580

Connector Membership $ 1,200

Builder Membership $ 2,500

Visionary Membership $ 5,000

Not sure where you fit? Contact us for more information. Please contact us to determine the fee.

Member Application