Membership Application Thank you for your interest in joining the El Dorado Hills Chamber of Commerce. We offer four convenient ways to join: ONLINE. Sign up online using the Member Application below. PHONE. Call us at 916-933-1335 MAIL. Print out a Member Application and return to: El Dorado Hills Chamber of Commerce, 2085 Vine Street, Suite 105, El Dorado Hills, CA 95762 FAX. Print out a Member Application and fax to us at: 916-933-5908 MEMBER APPLICATION Please provide us with as much information as possible, so that we may process your application request accurately and completely. Security Notice: Please note we transmit your data from this form using a secure server. Your Business Information Organization Name * Address 1 * Address 2 City * State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip * Phone * Fax Website Email * Main Contact First Name * Last Name * Title Business Phone * Mobile Phone Email * Additional Contacts First Name Last Name Title Email First Name Last Name Title Email First Name Last Name Title Email First Name Last Name Title Email First Name Last Name Title Email Billing Address (if different) Street City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Additional Information Business Description Communication Preference MailPhoneEmail Reason for Joining: Networking Business Development Advocacy/Policy Development Advertising Special Events Business Directory Support the Community Workshops Special Interests: (check all that apply) BrewFest Art, Beer & Wine Festival Ambassador Program Biz Walk El Dorado Hills Member to Member Discounts Membership Investment Membership Type: * Connector Non-Profit Connector Catalyst Convener Premier Partner Premier Partner Plus Primary Directory Category * None Accountants Certified Public Accounting Services Acupuncturists Adoption Agency Advertising Advertising - 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Kitchen Cable Camps Car Show Car Washing & Polishing Cardlock & Petroleum Distributor Care Management Services Carpet & Rug Dealers - New Carpet, Rug & Upholstery Cleaners Casino Party Rentals Casinos Caterers CD Rom & Video Production Cellular - Retail Cellular & PCS Telephone Service Cement Products & Services Cemetery Chambers of Commerce Child Care Chiropractic Doctors Churches Cigars - Sales & Manufacturing Cleaners Clinics - Medical Closets - Custom Clothing - Women Retail Clothing Resale Clothing Sales - Consultant Clubs & Organizations Coaches - Business & Personal Cocktail Lounge Coffee Houses Coffee Service Collection Agencies College Planning & Test Prep Communications-Telecommunication Consultants Community Services District Computer & Computer Equip Service & Repair Computer Disaster Recovery Computer Network Design & Systems Computer Products Computer Software & Services Concrete - Decorative Consignment Services Construction - Equipment Rental Construction Consulting Services Construction Management Contractor Referral Service Contractors Contractors - Commercial Contractors - Electric Contractors - General Contractors - Kitchen & Bath Contractors - Residential Contractors - Roofing Convenience Store Copy & Duplicating Service Copy Machines - Supplies & Parts Corporate Housing Cosmetic, Plastic & Reconstructive Surgery Counseling Services Counter Tops Country Club - Private Credit Card Merchant Services Credit Unions Crisis Intervention Cruises Dancing Instruction Database Design Day Spas Delicatessens Delivery Services Dental Equipment - Repairing Dentists Dentists - Cosmetic Dentists - Implants Dentists - Orthodontics Dentists - Pediatric Department Stores Designer - Industrial Designer/Goldsmith Digital Signs Disappearing Screens For Doors & Windows Distillery Document Imaging Document Management Document Scanning Dog Trainer Doors Draperies Driving Instruction E-Commerce Economic Development Organizations Education Education & Training Educational Consulting & Services Electric Companies Electrical Contractor Electronic Contractors Electronics - 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Auto Glass Plate & Window Golf Course - Private Golf Course - Public Golf Instruction Gourmet Food Shops - Retail Government Grant Writer - Developer Graphic Designers Grocers & Markets - Retail Gymnastics Instruction Handyman Services Hardware Hardwoods Hauling Health - Wellness Health & Fitness Clubs Health & Fitness Consultants Health & Wellness Products - Retail Health Plans Health Services Hearing Aids & Assistive Devices Heating & Air Contractors Hobby & Model Supplies - Retail Holistic Practitioners Home & Garden Home Builders Home Entertainment Systems Home Furnishings & Accessories Home Health/Care Services Home Inspection Service Home Repair Home Services Information & Referrals Home Staging Horseback Riding Hospices Hospitals Hot Dog Vendors Hotels House Cleaning Housewares Human Resources Human Resources Consultants Ice Cream & Frozen Desserts Identity Theft Image Consultants Independent Living Individuals Information Technology Equipment Information Technology Services In-Home Care Inspection Services Insurance Insurance - 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Communications Mediation-Arbitration Medical Centers Medical Supply Memory Care & Alzheimer's Services Mobile Home Park Mortgage Loans & Services Mortgages - Reverse Movers & Storage Movie Theaters Moving Services Murals Museums Music - Instruction/Entertainment Musical Entertainment Nail Salons Nannies Networking Organizations Newspapers Non-Profit Notary Notary - Mobile Nursery - Trees, Plants, Etc. Retail Nursing Homes Nutrition & Fitness Nutrition Education Nutritionist Office & Desk Space Rental Service Office Furniture & Equipment - Dealers Office Services - Offsite Office Supplies Oil Change & Lube Olive Oil Optometrists & Opticians Oral & Maxillofacial Surgery Orchestras, Symphonies & Bands Organizational Management Consultants Organizing Services Orthopedic Appliances Pain Management Paint - Retail Paint and Sip Painting - Decorative & Faux Finishes Painting Contractors Paper Destruction Party Favors, Supplies & Services Party Planners Party Rental & Tenting Party Supplies Renting Patio Covers Patio Furniture Payroll & Taxes Payroll Services Performance Training Personal FitnessTrainers Personal Life Coaching Personal Services & Assistants Pest Control Services Pet - Boarding Pet Grooming Pet Sitting Pet Supplies & Foods Retail Pharmacies Phone Answering Service Photographers - Wedding Photographers- Commercial Photographers- Portrait Physical Therapists Physicians Physicians - Dermatology Physicians - Family Medicine Physicians - Integrative Medicine Physicians - Obstetrics & Gynecology Physicians - Orthopaedic Surgery Physicians - Plastic & Reconstructive Surgery Physicians - Sports Medicine Physicians - Urgent Care Piano Sales & Service Company Picture Framing Pizza Plumbing Contractors Plumbing Service & Repairs Pond Supplies Pool Service & Repair Popcorn & Candy - Retail Portable Toilet Rental Portfolio Management Pottery - Retail Presentation Services Printers Printing Equipment Printing Supplies Professional Organization Services Professional Photo Organization Property Management Psychics Psychologists Psychotherapists Public Relations Consultants Publishers - Book, Periodical & Magazine Publishers - Maps Rafting Real Estate - Loans Real Estate - Appraisers Real Estate - Broker Real Estate - Commercial Real Estate - Developers & Developments Real Estate - Equestrian Properties Real Estate - Residential Refrigeration Equip - Commercial Sales & Serv Rehabilitation Services Relocation Services Remodeling & Repairing Building Contractors Remodeling Contractors Researchers - Sonics & Ultrasonics Restaurants Restaurants - Desserts Retirement & Life Care Communities & Homes Retirement Planning Retreat Facilities Sales/Training/Seminars Satellite & Cable TV Equip & Systems Schools Schools - Colleges & Universities Schools - Pre School Screen Printing Screens/Retractable Secretarial Services Security Serv & Systems Self Defense Products Senior Assisted Living Senior Citizen Services Service Stations - Gas & Oil Sheriff's Department Shipping Services Shoes - Retail Shopping Centers & Malls Shower Doors & Enclosures Shuttle Service Signs Ski Resorts Skin Care Sober Living Soccer Training School Social & Human Servs for Individuals & Families Software / Technology Solar Products - Dealers & Services Sound Systems & Equip Spas, Fireplaces & Stoves Speech Therapy Spinning & Weaving Sporting Goods Sports Recruiting Sports Team Statuary Steam Cleaners Storage - Self Service Suicide Prevention Supervisors Surgery Centers Swimming Instruction Swimming Pool - Designing & Consulting Swimming Pool Contractors Swimming Pool Renovations, Repair & Serv Synagogues Tailors Tanning Salons Tax Return Preparation Taxes Consultants & Representatives Tea & Coffee Bar Telecom Consulting Telecommunications Telecommunications Dealers & Installation Temporary Services Theatre - Youth Therapists - Marriage & Family Tile Cleaning, Refinishing & Sealing Tire Dealers- New Title Companies Toner Cartridges Tourism Toys - Retail Trade Shows, Expositions and Fairs Transportation Travel Agencies Tree Service Tutoring / Academic Mentoring Unclaimed Funds Retrieval Services Uniforms Urgent Care Clinic Veterinarians Video Games Video Production & Editing Vineyard Virtual Assistant Virtual Tours Warehouse Clubs Water & Sewer Utility Company Water Companies Bottled & Bulk Water Damage Emergency Service Water Damage Restoration Water Sports Web Site Design Wedding - Consultants Weight Management Welcome Services Window Shades & Treatments Window Cleaning Window Tinting Windows Wine Cellars Wine Consultants Wine Storage Wine Tours Wineries Winery Associations Wines - Retail Wire, Cable, Fiber Obtics Yoga/Meditation Yogurt Additional Directory Categories Primary Directory listing is complimentary Additional Directory listings are $35 each **Hold CTRL on your keyboard to select multiple categories** none Number of Full Time Employees: Number of Part Time Employees: Annual Membership Investment High School Scholarship Donation $ Voluntary BACPAC Contribution $ Additional Categories Cost $ One-Time Administrative Processing Fee $ Total: $ The contents of this box are for testing purposes. This box will be removed when the form goes live. Full-Time Employees Part-Time Employees AdditionalCategories Additional Categories Cost NumberOfAdditionalCategories High School Scholarship Donation Voluntary BACBAC Contribution Annual Dues (charged to card) Fee (charged to card) tempValueForDropDown1 Payment Type * Credit Card Check NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks. Automatic renewal annually? * Yes No Membership dues are not deductible as charitable contributions for Income Tax purposes. Dues may be considered ordinary and necessary business deductions. 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