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Please note that dues rates may increase effective April 1, 2019. If you would like to pay monthly membership dues please call Fran Diffenderfer at 717.718.7845

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

School District: *

Municipality: *

Primary Reason for Joining:

Minority Owned:

Woman Owned:

Veteran Owned:

Residential:

Commercial:

Do not publish address:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Social Networking:

LinkedIn Facebook Twitter Google+ youtube

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Google+ youtube

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Google+ youtube

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Membership: See fee schedule to determine the fee and enter it below.
Your annual dues are based on your company's employee count. If using fee schedule, enter fee here:

Additional Fees:

Processing Fee : $30.00
New membership processing fee

Payment Option:

Charge my credit or debit card

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YORK, PA 17401
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F: 717.843.8837

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