Member Form Company NameAddress Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Main PhoneAlternate PhoneFaxEmail Website Facebook Twitter Instagram LinkedIn Google+ Other Name First Last Email Type of BusinessDescription of business to be used for your public company profile on our business directoryYears in BusinessOwner NameNumber of Employees (Including Owners)Mailing Address (if different from above) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Preferred Method of ContactEmailFaxMailTelephonePlease state your reason for joining the Carleton Place ChamberPresentation by membership coordinatorAnother member referred meJust opened a businessWord of mouthWhat are the top three Chamber offerings you consider to be of most value to you/your business?NetworkingCost Savings from Affinity ProgramsGroup InsuranceEducational WorkshopsDesire to Support ChamberSpecial EventsI would like to participate on the following committees/eventsNone at this timeChamber BoardGolf CommitteeGala CommitteeMember Value CommitteeChamber Finance CommitteeWorkshopsGuest SpeakerMember to Member (M2M) Discount ProgramYesNot at this timeUnsureIf you answered YES, please provide details of your discount/offer belowBy checking this box you agree to receive Chamber news, messages, notices and any other information that the Chamber deems important to its members via email or through a personal telephone call. If you do not wish to receive our emailed material, there is an unsubscribe link at the bottom of the email.* I Agree Please enter extra emails if they would like to be included in our mailing listThe mandate of the Carleton Place and District Chamber of Commerce is to facilitate contact between its members. In order to do this, the Chamber will publish your business information on its website. The Chamber will also share your contact information with other Chamber members and Chamber special discount sponsors. By checking this box you agree to these terms* I Agree EventsChamber News Coffee at the Chamber Carleton Place Chamber Office170 Bridge Street Jan. 08, 2019, 8:00 am - 9:30 am12 @ 12 Carleton Place Chamber Office170 Bridge Street Jan. 17, 2019, 11:30 am - 1:00 pmBusiness at Breakfast – AGM Mississippi Golf Club341 Wilson Street Jan. 30, 2019, 7:30 am - 9:00 amSEO to increase your online presence Mississippi Golf Club341 Wilson Street Jan. 30, 2019, 10:00 am - 12:00 pmCoffee at the Chamber Carleton Place Chamber Office170 Bridge Street Feb. 05, 2019 - May. 02, 2019, 8:00 am - 9:30 am 5 Ways the Chamber Can Make Your Professional Life Easier12 Days of Christmas RaffleLegion finalizes plans for Remembrance DayOntario Government Taking Bold Action to make the province Open for BusinessRemembrance Day Parade and CeremonyVOTE 2018BR + E Project Lanark CountyMental Health at Work Makes Good Business SenseIt’s Not too Late for Camp!Keep Cool On Canada Day
