Username Password Verify Password Trade/Company Name Service Type Accounting Banking Cleaning Company Construction Consulting Firm Community Service Electrician Financial Advisor Financial Institution Insurance Legal Service Landscaping Loan and Mortgages Marketing Non Profit Painting Pest Control Real Estate Restaurant Technology Telecommunications Translation Service Transportation Medicine Newspaper Service Security Shipping Company Other Years in businessl 1 2 3 4 5 6 7 8 9 10 11 12+ Application Type INDIVIDUAL GROUP BUSINESS Primary Applicant Information First Name Middle Name Last Name Website Country of origin Home Phone Work Phone Cell Phone Email Verify Email Street Address City State / Canada AL AK AZ AR CA CANADA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY Zip PLEASE COMPLETE THE FOLLOWING SURVEY company at least 51% woman owned? YES NO 51% Hispanic owned? YES NO member of any local chamber of commerce? YES NO U.S. SBA (Small Business Administration) Hub Zone Certified? YES NO SBA (Small Business Administration) Certified? YES NO Women/Minority Certification: New Jersey New York New York City Other Approved Vendor List USHCC CCR Other Reason for joining this chamber Marketing/Networking Benefits/Savings Public Policy Information/Assistance Programs Support/Civic Duty Training Other I certify the above information is true and correct. I agree to allow my name and business information to be shared as a member of MCHACC YES NO