OneZone Chamber of Commerce Application To view this form, please enable JavaScript in your browser. Thank you for joining OneZone. Look for your welcome packet and OneZone window cling in your mailbox soon. To pay by credit card, complete the information below and submit. To pay by check or cash, contact us by email or phone at 317.436.4653, or download the membership application and submit to us with payment. Organization Information (to be displayed online) Organization Name Main Contact First Name Main Contact Last Name Title Address 1 Address 2 City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Phone Email Website Is this a Woman Owned Business? Select one... Yes No Is this a Minority Owned Business? Select one... Yes No Are you a Veteran Owned Business? Select one... Yes No Would you like to contribute to the OneZone PAC? Select one... Yes No How did you hear about OneZone? Additional Contacts Contact 1 First Name Last Name Title Email Address Is this person a young professional under 40? Select one... Yes No Contact 2 First Name Last Name Title Email Address Is this person a young professional under 40? Select one... Yes No Contact 3 First Name Last Name Title Email Address Is this person a young professional under 40? Select one... Yes No Contact 4 First Name Last Name Title Email Address Is this person a young professional under 40? Select one... Yes No Contact 5 First Name Last Name Title Email Address Is this person a young professional under 40? Select one... Yes No Contact 6 First Name Last Name Title Email Address Contact 7 First Name Last Name Title Email Address Contact 8 First Name Last Name Title Email Address Contact 9 First Name Last Name Title Email Address Contact 10 First Name Last Name Title Email Address Add/Remove Contacts Membership Investment Membership Type Select one... 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Water & Storm damage Employee Benefits Employment Services/Staffing Engineering Services Environmental Consultants Event Planning & Services Event/Specialty Family Entertainment Center Festivals/Events Film Digitization Financial Services Fire Protection Fitness Centers/Swim Centers Fleet & Leasing Sales Flooring Florists Food Truck Food/Specialty Shops Foodservice Wholesalers Formal Wear Fraternity Funeral Homes Furniture Store Gasoline Stations with Convenience Stores General Contractor Geospatial Glass & Mirror Golf Courses & Country Clubs Government Grocery Stores Handicap Services Hardware Health & Wellness Healthcare Services Hearing Aids Heating & Air Conditioning Home Builders Home Healthcare Services Home Remodeling, Improvements, Repairs & Maintenance Home Theater Hospitals Hotels Human Resources Consulting Hydraulic Repairs Identity Theft Services Information Technology Services Infusion Center Inspections Insurance - Automobile/Aviation/Marine Insurance - Health Insurance - Home/Garden Insurance Services Interior Design Services Internet Service Provider Investment Services IT Staffing and Consulting Jewelers Kitchen Sales Landscape Architecture Landscape Maintenance Landscaping - Residential/Commercial Language Services Lawn Maintenance/Lawn & Garden Equipment Lawn Sprinkler Installation/Service Leadership Training Legal Services Libraries Lighting/Lighting Showroom Limo Service Liquor Stores Locksmith Logistics Manufacturers/Representatives Marketing - Digital Marketing Services Martial Arts/Karate Massage Therapist Mattress Manufacturer & Retailer Media/Video Production Medical Billing Medical Equipment Medical Imaging Center Medical Office Mental Health Merchant Services Midwifery Services Mobile APP Development Mortgage Companies/Brokers Motorcycle Dealers Movers Movie Theaters Multimedia Museums Music - DJ Music - Instruments/Instruction Nanny Services Notary Services Office Furniture & Equipment & Office Supplies Online Services Optometrists/Opthalmologists Orthodontics Painting Classes Painting/Drywall Parking Management Parks & Recreation Sports Centers Party Rental Equipment Payroll Services Performing Arts - Theater/Dance/Music Personal Services & Care Personal Training Pest Control Pet Care Services/Products Pet Cemeteries Pharmaceutical Photo Booth Photo Digitization Service Photography/Gallery/Studio Physical/Occupational/Speech Therapists & Audiologists Physicians Plumbing/Plumbing Supplies Political Organization Pools/Spas Printing/Mailing/Marketing Solutions Private Banking Services Professional Clothier/Tailor Promotional Marketing/Products Property Management/Office Space/Leasing Property Tax Consultants Public Affairs/Lobbying Publishers/Newspapers Quality Control Service Real Estate - Commercial/Development/Land Development Real Estate - Residential Redevelopment/Urban Planning Relationship Development Relocation Renewable Energy Consultants Repair - Fitness Research/Development Restaurant Services Restaurants Restoration/Renovation Retail Banking Retail/Specialty Stores Retiree Retirement Planning Risk Management Roofing Safety Training Schools Secure Records Management Security Services Self-Storage Senior Living/Independent/Assisted Living Communities Senior Services Shipping/Packing Shopping Centers & Mall Shredding/Document Destruction Services Signs/Sign Manufacturing Skincare/Aesthetics Small Business Banking Snow Removal Software Solutions/Development/Engineering Spa/Salon/Beauty Shop Sports Events Sports Medicine Sports Teams & Clubs Sports Training Sports Uniforms State Representative Succession Planning Supermarkets & other Grocery Stores Surgical Services Surveyors and Consulting Engineers Tanning Salon Tax Preparation Services Technology Services Telecommunications Consulting & Services Television & Broadcasting/Stations Tennis Clubs Ticket Sales Title Insurance & Services Tourism Traffic Signs, Signals & Lighting Installation Training - Professional & Management Development Transportation Services Trash Services Travel Agency Tree/Shrub Services Tutoring & Exam Preparation Uniforms Urgent Care Utilities/Energy Analyst Vehicle Wraps Vending Services Veterinary Services Warehouse Clubs & Super Centers Warehouse Management Water Systems Wealth Management Solutions Website Development Wildlife Services Window Cleaning Window Tinting Windows & Siding Womens Health - Breast Center Additional Directory Categories Select additional directory categories below by holding the "CTRL" key none Number of Full Time Employees Number of Part Time Employees Business Type Business to Business Business to Consumer Business Size Large (10+ million in sales) Small (10 million or less in sales) The contents of this box are for testing purposes. This box will be removed when the form goes live. Full-Time Employees Part-Time Employees Hotel/Motel Rooms Restaurant Seats Additional Associates Additional Associates Cost Additional Locations Additional Locations Cost Assets Assets Cost Additional Categories Number Of Additional Categories Additional Categories Cost Additional Item 1 Cost Additional Item 2 Cost Additional Item 3 Cost Additional Item 4 Cost Additional Item 5 Cost Additional Item 6 Cost Additional Item 7 Cost Additional Item 8 Cost Additional Item 9 Cost Additional Item 10 Cost Annual Dues (charged to card) Revenue Item Tax (charged to card) Fee (charged to card) Temp Value For DropDown 1 MembershipType Additional Item 1 Additional Item 2 Additional Item 3 Additional Item 4 Additional Item 5 Additional Item 6 Additional Item 7 Additional Item 8 Additional Item 9 Additional Item 10 Payment Type Credit Card Check NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks. Number of Rooms Number of Seats Number of Associates Number of Locations Millions in Assets Additional Items One-Time Application Fee Tax Credit Card Information Copy from Organization Information Credit Card Type MastercardVisaDiscoverAmex Credit Card Number Name on Card Security Code Valid Through 01 02 03 04 05 06 07 08 09 10 11 12 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NL NS NT NU ON PE QC SK YT AG BN BS CH CL CM CP DF DU GR GT JA MC MR MX NA OA PU QE QR SI SL SO TB TL TM VE YU ZA Outside US Outside Canada Outside Mexico Zip Phone Credit Card Email Address Click Submit button only once. This transaction may take several seconds. A confirmation screen will show when confirmed. Please select a membership type before submitting your application.