Please fill out the information below to begin the process of membership in the Souhegan Valley Chamber of Commerce. Membership dues can be found here.

Date:
Referred By:
Business/Organization Name:
Street Address:
Mailing Address:
City / State / Zip:
Business Phone:
FAX:
Web Site Address
Primary Contact Person:
Primary Contact Email:
(Secondary Contact Person Will Receive a Copy of Mailings)
Secondary Contact Person:
Secondary Contact Email:
Business Category:	Select One Accountants Air Conditioning / Heating Antique Cars Antiques Apartments Apparel Appliance Sales & Services Appraisal Services Art Galleries / Instruction Automobile Sales & Services Banks & Banking Associations Banquet & Catering Book Stores Books New & Rare Boutiques & Specialty Shops Business & Organizing Services Chiropractors Civic Organizations Cleaning / Restoration Coin Dealers / Collectibles Computer Services Confections Conservation Education Construction / Contractors Credit Card Processing Credit Unions Dance Instrucion Dental Practices Elder Housing Electricians Employment & Staffing Services Family Services Financial Services Fitness Facilities Florists Fuel Funeral Homes Furniture Retail Garden Center & Nurseries Gifts Government Graphic & Website Design Services Gymnastics Instruction Health / Wellness Services Home Health / Nursing Homes Home Improvement Hotels and B & B Insurance Jewelry Landscaping Contractors Law Offices Libraries Lighting Limousine Services Management Consultation & Training Manufacturing Marketing / Promotion Markets Massage Therapy Mortgage Services Moving & Storage Music / Performing Arts Newspapers Office Equipment & Supplies Optometrists Orthodontics Painting Party & Event Rentals Paving & Plowing Personal Chef Pets Photography Physical Therapy Physicians & Surgeons Postal / Package Services Printing / Publishing Propane Property Management Public Relations Real Estate Recreation / Golf Restaurants Retail Retreat Center Salons & Spas Schools Scrapbooking Septic Services Shopping Centers Sign Manufacturing Sporting Goods Stoves – Wood Supermarkets Surveyors & Engineering Take-Out Foods Telecommunications / Communication Tire Dealers Tractor Sales & Service Trash Removal US Military Utilities Veterinary Medicine & Surgery Voice Over Services
Company Description (300 characters maximum):
Type of Business/Organization:	Select One Owner/Operator/Individual Business, Professional Associations, & Small Corporations 1 – 10 employees Business, Professional Associations, & Small Corporations 11 – 50 employees Manufacturers, Utilities, & Large Corporations, 51 or more employees Banks & Credit Unions Non-Profits (applies to 501C3’s only) with an annual budget under $250,000 Non-Profits (applies to 501C3’s only) with an annual budget over $250,000 Civic, Towns, Schools Retired Executive
Membership Level:	Select One Base Premier
Would you like 2nd business listing? (same business, different address)? Yes   No Do you give a discount to other Chamber members? Yes   No Do you give a discount to Seniors? Yes No You may click on the SUBMIT button below or print a copy of the completed form to mail with your membership dues. Please submit your dues to Souhegan Valley Chamber of Commerce, 69 Route 101A, Amherst, NH 03031. Your membership will not be processed until payment is received.