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PublicLayout
Erik
2021-05-03T09:15:20-05:00
Member Application
Please fill out the form below to process your application. If you have any questions, please contact us at 617-471-1700 or email our Membership Director, Celia Hussey at chussey@thequincychamber.com
Step 1:
Member Info
Step 2:
Additional Info
Step 3:
Primary Contact
Step 4:
Billing Contact
Step 5:
Membership Options
Step 1:
Member Info
Company Name
*
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Phone
*
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Email
*
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Physical Address
Address line 1
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Address line 2
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Afghanistan
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Australia
Austria
Azerbaijan
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Bangladesh
Belgium
Belize
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Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
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Ecuador
Egypt
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Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
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Greenland
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Hungary
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India
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Japan
Jordan
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Macedonia, FYRO
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Poland
Portugal
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Romania
Russia
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South Africa
Spain
Sri Lanka
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Switzerland
Taiwan
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State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Mailing Address
Same as physical address
Address line 1
*
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Address line 2
Country
*
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Please add your country.
City
*
Please add your City.
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Social Network Addresses
LinkedIn
Facebook
Instagram
Twitter
Step 2:
Additional Info
Business Description (200 char max)
Directory Category
*
Choose...
Accounting
Advertising
Ambulance
Answering Service
Appliances & Electronics
Appraisal Services
Architects
Architectural & Engineering Supplies
Art
Assisted Living
Associations
Attorneys
Auction/Residential & Commercial
Automotive
Bakeries
Banks/ Credit Unions
Beauty & Cosmetics
Biotech
Bridal
Building Restoration
Business Services
Cable/Wiring
Cannabis
Catering
Chemical Manufacturing
Child Care
Chiropractic
Cleaning Services
Clothing
Computer Services & Training
Construction
Construction Equip/Supplies/Service
Consultants
Credit Card Processing
Dental
Development
Document Services
Dry Cleaners
Education & Schools
Elder Care
Electrical
Elevator & Escalator Service
Employment & Training
Energy
Engineering
Entertainment
Environmental
Equipment
Event Planning
Financial Education
Financial Services
Financial Strategy
Fire & Water Restoration
Fire Protection
Fitness
Floor Coverings
Florists
Food & Beverage (Specialty)
Fuel/Oil
Function Facilities
Funeral Services
Furniture
Gifts
Government
Graphic Design
Hardware
Health & Wellness
Healthcare Facilities
Heating
Historic Museum
Home Care for Individuals
Hotels, Motels & Lodging
Human Resources
Human Services
HVAC
Import/Export
Industrial
Insurance
Interior Design
Internet Services
Interpretation & Translation
Janitorial Services
Jewelers
Jewelry & Accessories
Laundromat
Lawn & Garden
Lighting
Locks & Locksmith
Mail Services
Manufacturing
Marina
Marketing
Massage Therapy
Media
Medical Equipment
Mortgage
Moving Services
Music
Non-Profit
Nutrition
Office Center/Office Leasing
Office Supplies & Equipment
Online Website
Opthalmologist
Optometrist/Opticians
Paint Supplies
Painting
Payroll Services
Personal Assistant
Pest Control
Pet Care & Services
Pharmaceutical
Photography
Physical Therapy
Physicians
Places of Worship
Plumbing
Printing
Promotional Products
Public Access
Public Relations
Public Utility
R.E. Commercial
R.E. Development
R.E. Management
R.E. Residential
R.E. Residential Rentals
Recreation & Sports
Recycling
Restaurant/Pubs
Retail
Security
Self-Storage
Services/Consulting
Shipping
Signs & Signage
Skilled Nursing Facility
Software
Staffing
Supermarkets
Supplies & Services
Surveying
Tax Services
Telecommunications
Tourism
Towing
Transportation & Travel
Vended Water
Warehouse & Storage
Waste Removal
Waterproofing & Roofing
Web Design
Wedding Services
Wholesale
Window Cleaning
Please select a directory category.
Full-time Employees
*
Please add your number of full-time employees.
Part-time Employees
*
Please add your number of part-time employees.
Step 3:
Primary Contact
First Name
*
Please add your first name.
Last Name
*
Please add your last name.
Title
*
Please add your title.
Phone
*
Please add your phone number.
Cell Phone
Fax
Email
*
Please add a valid email.
Contact Preference
Email
Phone
Address
Same as Address in Step 1
Address line 1
*
Please add your address.
Address line 2
Country
*
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Please add your country.
City
*
Please add your City.
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please add your State.
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Social Network Addresses
LinkedIn
Facebook
Instagram
Twitter
Create Account
This Login is already in use
Login
*
Please add your login username.
Password
*
Please add your login password.
Step 4:
Billing Contact
Same as Primary Contact
First Name
*
Please add your first name.
Last Name
*
Please add your last name.
Title
*
Please add your title.
Phone
*
Please add your phone number.
Cell Phone
Fax
Email
*
Please add a valid email.
Contact Preference
Email
Phone
Address
Same as Primary Contact Address
Address line 1
*
Please add your address.
Address line 2
Country
*
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Please add your country.
City
*
Please add your City.
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please add your State.
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Social Network Addresses
LinkedIn
Facebook
Instagram
Twitter
Create Account
This Login is already in use
Login
*
Please add your login username.
Password
*
Please add your login password.
Step 5:
Membership Package
Please select a Membership Package
Kilroy Square Market Vendors
$
195
For those brick and mortar pop-up artisan and specialty shop vendors who participated at the Kilroy Square Market
Level I
$
295
Level II
$
385
Level III
$
550
Level IV
$
750
Level V
$
1,000
Payment Option
Charge my credit or debit card
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