(Please note that your dues must be paid in full by February 3rd in order to be included in the Ebensburg Business Directory)

Total Due: $50.00
Pay Dues Online

Items with a * are required for the form to process correctly

Business Name

Email Address

Phone Number

Fax Number

Would You Like Your Email Address Posted Online
YesNo

Website URL

Mailing Address

Business Description

Contact Person

Number of Full Time Employees

Number of Part Time Employees

Business Category
AutoBeautyCivic/ClubEntertainmentFinancialHealth RelatedInsuranceLegalLodgingReal EstateReligiousRestaurantRetailServiceSpecialityTechnical

Other Business Type

*Signature

*Date