Online Application

Complete the following application fields and click submit at the bottom.

Note: This process will use the latest SSL Security Encryption to protect your information. Use your credit card with confidence.

Company Name
Mailing Address
City
State
Zip
Company Phone
Fax Number
Company Website
Company Email Address
Main Representative
First Name
Last Name
Title
Direct Line
Cell Phone
Email Address
Number of Employees
Full-time
Part-time
Category
Annual Investment
(2 part-time employees = 1 full-time)
300-plus Employees, Banks, Universities, & Public Utilities:
Please call the Chamber at (203)925-4981 to discuss investment schedule.
A $25.00 one time application fee will be also be charged.
IMPORTANT NOTE:
Membership is continuous unless cancelled in writing. For federal income tax purposes, your membership in the Greater Valley Chamber of Commerce, as well as any other contributions to the Chamber, may be deductible, as ordinary and necessary business expenses and not as a charitable contribution.
Payment Options
Note: This process will use the latest SSL Security Encryption to protect your information. Use your credit card with confidence.
 Credit Card Number    
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Country
Pay By Check:  Please call Chamber office at (203) 925-4981
If you have been in contact with another Chamber member or a Chamber Staff Person prior to submitting this application, please enter his/her name below:
Our membership Director will confirm receipt of this application by phone.
Please click submit only one time.  The transaction may take several seconds.

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