3 Converse Street, Suite 103  •  Palmer MA 01069  •   (413) 283-2418  •  Fax: (413) 289-1355
 
Welcome!
 

Member Application:

* Company Name:  
* Phone:  
Website:
* Email:
* Business Description (200 char max)
* Business Keywords:
 
* Physical Address:  
* City/State/Zip:  
Country:
 
Mailing Address: Same as physical address
City/State/Zip:
Country:
 
Business Category:
* Employees: Full-time:      Part-time: 
Comments/Questions:
 
 

Primary Contact Information:

* Name (First / Last):  /   
* Phone:  
Cell Phone:
Fax:
* Email:  
Contact Preference: Email  Phone
 
Address: Same as Company Address
City/State/Zip:
Country:
 
 

Billing Contact Information:
Same as Primary Contact
Name (First / Last):  /   
Phone:  
Cell Phone:
Fax:
Email:  
Contact Preference: Email  Phone
 
Address: Same as Company Address
City/State/Zip:
Country:
 
 
Membership Package:
Category 1: 
Retail, Service or Individual Annual Investment Number of Employees 1-5 $ 242.00
Category 1: 
Retail, Service or Individual Annual Investment Number of Employees 6-24 $385.00
Category 1: 
Retail, Service or Individual Annual Investment Number of Employees 25-49 $500.00
Category 1 : 
Retail, Service or Individual Annual Investment Number of Employees 50-99 $632.50
Category 1: 
Retail, Service or Individual Annual Investment Number of Employees 100-250 $800.00
Category 1: 
Retail, Service or Individual Annual Investment Number of Employees 250+ $1099.00
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