Member Application
We'd like to welcome you to the world of networking available through your Antioch Chamber Membership. There are so many ways we can assist in the promotion of your business/organization - we look forward to partnering with you.
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
*
Please add your company name.
Leave Blank
Phone
*
Please add your company phone number.
Website
Email
*
Please add a valid email.
Physical 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 & Herzegovina
Bosnia and Herzegovina
Botswana
Brazil
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
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
North Macedonia
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 & Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vatican City
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.
Mailing Address
Same as physical 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 & Herzegovina
Bosnia and Herzegovina
Botswana
Brazil
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
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
North Macedonia
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 & Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vatican City
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
Step 2:
Additional Info
Business Description (200 char max)
*
Please add your company description.
Business Keywords
*
(enter a space between words)
Please add your business keywords.
Directory Category
Choose...
Accountants
Advertising
Air Conditioning & Heating
Air Purification-Indoors
Antiques
Apartments & Condos
Architect
Architect
Architect
Architect
Art
Arts & Crafts
Assisted Living
Attorneys & Legal Insurance
Auto Body Work & Paint
Auto Dealers
Auto Parts & Accessories
Auto Parts & Repairs
automotive windows
Awnings
Bakery
Ball Club & Sport Teams
Banking
Banquet Hall
Bar and Restaurant Equipment
Bikes
Blinds & Window Coverings
Boat Rentals
Boat Repairs
Boat Storage
Boating Safety
Boating/Watersports
Books & Magazines
Brokerage Firms & Investments
Camping, Fishing & Hunting
Cannabis
Car Washes
Cell Phones & Paging
Chamber of Commerce
Child Care
Chiropractors
Churches & Religious Organizations
Civic Groups/Non Profits
Cleaning & Sanitation
Cleaning Services
Clothing
Colleges & Universities
Computer Services
Consignment
Construction
Consulting & Management
Counseling
Crafts & Hobbies
Dance
Dentists
Department Stores
Dry Cleaners
Electrical
Electrolysis
Embroidery
Emergency Services
Employment
Exercise & Physical Fitness
Eye Care
Financial
Fire Alarms & Supplies
Fishing
Flooring
Flowers
Food & Dining
Food Stores & Supermarkets
Freight
Garages and Garage Doors
Gift Shops
Golf
Government
Grilling & Outdoor Entertainment
Grooming - Pets
Guns & Ammunition
Hardware, Houseware & Homefurnishings
Haunted House
Health & Diet Foods
Health Care
Health, Wellness & Fitness
Heating & Air Conitioning
Hospitals
Hotels & Motels
Identity Theft
Insurance
Interior Designs
Jewelry & Watches
Kitchen Remodeling & Construction
Landscaping
Laundry
Lawn & Garden
Leather Fashions
Libraries
Limos and Charters
Liquor & Wine Stores
Lumber
Manufacturing
Marketing
Martial Arts & Self Defense
Massage
Massage
Medical Centers & Clinics
Medical Gas Systems
Mobile Homes
Morticians & Mortuaries
Movies
Moving
Museums & Galleries
Music
Newspaper Publishers
Painting
Parenting
Party Entertainment
Pest Control
Pets
Pets & Pet Care
Phones
Photography
Physical Therapists
Picture Framing
Plumbing
Printing & Graphics
Public Schools
Publishing
Real Estate
Records
Remodeling, Repair & Improvement
Rental Equipment
Resale
Residential Windows
Restaurants
Retail
Roofing
Salons
Schools
Scouts
Senior Citizens
Septic Systems
Shipping
Signs, Lettering, Banners
Ski Resorts
Skin Care
Smoke Shop
Snow Removal
Social Services
Solar-Home Improvements
Stereos and Security & Alarm Systems
Storage
Supplies
Surveys
Surveys
Tannning
Tattoos
Theater
Toys
Training-Business
Trash and Haul Away
Travel Agencies
Tutoring
Upholstery
Utilities
Veterinarians
Vineyards
Waxing
Web Site Design
Wireless
Are you interested in Networking?
*
Looks good!
Want to Volunteer?
Interested in becoming part of our Ambassador Program?
If a new business, do you want a Ribbon Cutting?
Date the Business was Established?
*
Looks good!
Step 3:
Primary Contact
First Name
*
Please add your first name.
Last Name
*
Please add your last name.
Phone
*
Please add your phone number.
Cell Phone
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 & Herzegovina
Bosnia and Herzegovina
Botswana
Brazil
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
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
North Macedonia
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 & Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vatican City
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
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.
Phone
*
Please add your phone number.
Cell Phone
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 & Herzegovina
Bosnia and Herzegovina
Botswana
Brazil
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
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
North Macedonia
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 & Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vatican City
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
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
Full Membership-
$
195
Full Membership Package "For Profit" Businesses/Organizations
Associate Membership
$
65
Associate Membership "For non profit" businesses/organizations
Multiple Chambers Membership
$
97.50
annually
Switch to monthly autopay?
Multiple Chambers Membership Allows a 50% savings on a full membership when also a member of the Kenosha Area Chamber, WI
Multiple Businesses Membership
$
97.50
annually
Switch to monthly autopay?
Multiple Businesses Memberships Allows a 50% savings when joining for additional businesses owned by the same individual/partner.
Comments/Questions
Payment Option
Charge my credit or debit card
Please complete the Captcha
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