Non-Profit Organization Yearly Membership | The Greater Port Jefferson Chamber of Commerce

Applicant First Name:* Applicant First Name is Required

Applicant Last Name:* Applicant Last Name is Required

Contact Person (If different from applicant): Contact Person (If different from applicant) is not valid

Business Name:* Business Name is Required

Business Address:* Business Address is Required

Cell Phone: Cell Phone is not valid

Work Phone:* Work Phone is Required

Business Website: Business Website is not valid

Business Description: Business Description is not valid

Billing Contact Name:* Billing Contact Name is Required

Billing Email Address:* Billing Email Address is Required

Choose From The Following New Member Perks: Choose From The Following New Member Perks is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength Password must be "Medium" or stronger

PayPal

Pay via your PayPal account

No val Please fix the errors above

$200 for access until January 31, 2025

Invalid Coupon Coupon applied successfully

	Non-Profit Organization Yearly Membership – Payment $200 for access until January 31, 2025	$200.00
	Total	$200.00

Non-Profit Organization Yearly Membership – Payment

$200 for access until January 31, 2025

$200.00

Total

$200.00