Corning New York Chamber of Commerce
Corning Area Chamber of Commerce
Membership Interest Form


Contact Name
Title
Business Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Business Category
(Choose One)

General Membership

(Retailers, Manufacturers, Service Industries Insurance Firms, Accountants, Dentists, Doctors, Investment Firms, Lawyers, Veterinarians, etc.)

  Accommodation  

(Hotel/Motels and Bed and Breakfasts)
  Financial Institution

 
  Home-Based Business
 

(No employees / Operations at residence)

  Non-Profit Organization / Government Agency  

(Please submit copy of non-profit certificate)

     
No of Employees  
Work Phone  
FAX  
E-mail (Required)  
Website  
Prefer contact via E-mail Phone


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