Member Application Step 1: Member Info Step 2: Additional Info Step 3: Primary Contact Step 4: Membership Options Step 1: Member Info Company Name * Please add your company name. Leave Blank Phone * Please add your company phone number. 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 Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam 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 Address line 2 Country Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen 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 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 Postal Code Step 2: Additional Info Directory Category Choose... 360 Degree Virtual Tour Photography Accessories Accommodations Accountants Adult Home Advertising Advertisting Specialties Aging - In - Place Air Conditioning & Heating Ambulance Antiques & Collectibles Appliance Parts/Service Architect Art Studio/ Gallery Artists & Designers Arts Organization Attorney Audio/ Lighting Installation Author Auto Body, Detail & Recondition Auto Dealer Auto Parts & Supplies Auto Repairs/ Services Bagels Bakeries Bank Bars/ Nightclubs/ Pubs Beer Distributor Beverages Boat Dockage, Storage & Repair Boat Rentals Boat Yard Book Keeping Services Book Store Booster Club Bowling Brewery Bridal Shop/Accessories Business Networking Group Business Services Cafe Cameras & Telescopes Candy Cardiology Carpet & Rug Dealers Carpet Cleaning Catering Cell Phone Dealer Cell Phone Repair Cell Phone Services Cell Phones Cell Phones, Accessories Cemetery Charter Boats and Yacht Services Check Cashing Cheese Child Care Children's Clothing Children's Parties Chiropractor Cigars Cinema Arts Civic Organization Cleaning Services Clinical Social Workers Clothing Coffee Services Coffee Shop Collateral Loanbroker Colleges / Universities Comedy Entertainment Commercial Real Estate Community Services Computer Services Computer Supplies & Parts Construction Contractor/Construction Cooking School Court Reporting Credit Counseling Custom Printing Dance Instruction Dance Production Dance Studio Day Care - Child Debt Management Delicatessen Demolition Dentist Dessert Digital Marketing Digital Real Estate Disaster Restoration Discount Store Distillery Domestic Violence Services Drainage/Paving Education Elected Officals Electrical Contracting/ Inspection Electronic Bicycle Electronic Equipment & Supplies Electronics, Appliances Employee Benefits Consultant Employment Network Energy Efficiency Engineer Entertainment Environmental Remediation Event Planner Event Production Services Event Space Face Painting Ferry Service Festival/ Outdoor Amusement Planning Financial Services Fire Department Fire Protection Fitness Floor Repair Florist/ Garden Centers Food Markets Fraternal Organization Fuel Oil Funeral Home Furniture Furniture Cleaning Garbage Removal gardening Gifts/ Food Gifts/Collectibles Graphic Design/Website Gym Hair Salon Hardware, Lumber, Paint & Plumbing Headstones Health and Wellness Health Care Health Care Technology Hearing Aids Home Automation Home Health Care Home Improvement Home Maker Companion Home Repair/Restoration Hospital Hotels & Motels Ice Cream/Italian Ice Independent Sales Rep Instructional Art Studio Insurance Interactive Children's Website Interior Decorators Internet & Online Services Interpreation/ Translation Jewelry Junk Removal Kitchen & Bath Design Landscaping Large Format Digital Printing Law Office Lawn & Tree Maintenance Lawn Furniture Learning Center Lending/Investments Library Magazine Management Level Services Manufacturer Marina/ Services Maritime Marketing Consulting Martial Arts Massage Therapy Mattresses Media Medical Care Medical Message Therapy Medical Supplies Membership Warehouse Men's Clothing Mental Health Counseling Merchant Services Metrology Military Recruiting Miniature Golf Course Mobile Food Services Mobile Food Vendor Mortgage Services Museum Music & SAT Education Music Store Music Venue Nail Salons Neon Signs & lighting Newspaper Not for Profit Not for Profit Electrical workers Union Not for Profit Emergency Service. Not for profit- Domestic Violence Services Nursery School Nursing & Rehabilation Nutrition Office Supplies Office Technology On Demand Business Delivery Service Online News Open Art Studio Opthalmologist/Opticians Optometrists Paint/ Painting Supplies Painting & Wallpaper/ Removal Parts Distributor Party Rentals Payment Technology Payroll Performance Group Performing Arts Center Personal Trainer Pest Control Pet Grooming & Boarding Pet Shops & Supplies Pet walking/ Sitting Pharmacy Physical Therapy Physician Picture Framing Pizza Podiatrist Political Organization Portable Toilets Power Equipment Power Washing Printer Printing Services Production Company Professional Employee Organization Property Restoration Psychic/ Future Readings Psychologist Public Adjuster Public Relations & Marketing Publishers Radio Broadcast/ entertainment Real Estate Real Estate Development Religious Rental Service Residental Rentals Restaurant Retail Roofing Schools Search Engine Optimization (SEO) Security Self Storage Senior Living Senior Services Septic Tank Maintenance Service Service Organization Shoe Store Signs Singing Telegrams Sitter Services Skin Care Studio Small Business Marketplace Services Social Media Solar Energy Spa Special Needs Services Specialty Books Speech Therapy Sporting Goods Sports Leisure Storage Surgeons Surveyor Swimming Instruction Tax Preparation Tea Bar Teaching, Tutoring & Coaching Technology & Education Telecommunications Textile/ Fabric Textile/ Fabric Theaters & Concert Halls Tires Title Insurance Transportation Transportation Services Travel Agent Tree Removal Union Upholstery/Canvas Veterinary Hospital Virtual Enterprises/ Techonlogy Firm Vitamins & Suppliments Waste Removal/ Dumpster Rental Website Wedding Chapels Wedding Event/ Services Welcome Wagon Wholesaler Window Cleaning Wines & Liquors Women's Clothes YMCA Yogurt Youth Services 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. Phone * Please add your phone number. Email * Please add a valid email. Contact Preference Email Phone Address Same as Address in Step 1 Address line 1 Address line 2 Country Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bolivarian Republic of Venezuela Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo [DRC] Costa Rica Croatia Czech Republic Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Greece Greenland Guatemala Haiti Honduras Hong Kong Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Lao PDR Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia (Former Yugoslav Republic of Macedonia) Malaysia Maldives Mali Malta Mexico Moldova Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Principality of Monaco Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Serbia and Montenegro (Former) Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan U.A.E. Ukraine United Kingdom United States Uruguay Uzbekistan Vietnam Yemen 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 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 Postal Code Create Account This Login is already in use Login * Please add your login username. Password * Please add your login password. Step 4: Membership Package Please select a Membership Package Civic $ 145 Individuals, religious institutions and civic, fraternal and service organizations Small Business $ 290 All businesses, profit and not for profit with 9 employees or less Large Business $ 475 All businesses, profit and not for profit with 10 or more employees. Comments/Questions Payment Option Charge my credit or debit card Please complete the Captcha I have read and accept the privacy policy of Greater Patchogue Chamber of Commerce, Inc.. I grant Greater Patchogue Chamber of Commerce, Inc. permission to contact me regarding my account, news, updates, and offers. Please read and accept the privacy policy before continuing. Privacy Policy × Back Next Submit Application Print Application