Total Due: $50.00 – New members are free for the 1st year and can disregard payment section

Pay Dues Online – Select “Main Street Membership” from “Payment Description” drop down menu. 

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

    Business Name

    Your Email (required)

    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 EstateReligiousRestaurantRetailServiceSpecialtyTechnical

    Other Business Type

    *Signature

    *Date