Member Application Business Information Company Name: * Leave Blank: Phone: * Website: Email: * Business Description (200 char max): * Directory Category: --- Select Primary Category --- Accountants Advertising/Promotions Agriculture Alcoholic beverages Antiques/Estate Sales/Consignments Apartments Architectural Design & Building Art Galleries Arts & Crafts Assisted Living Attorneys Automotive Banks & Credit Unions Beauty Salons/Spas Books & Stationery Car Rentals Carpets & Interiors Childcare Childrens Clothing/Toys Chiropractors Churches Cleaning Services Clothing/Shoes Community Organizations Computer Service/Sales Construction Management Consultants Contractors Counseling Country Clubs Dance DEI professionals Dental Drug & Variety Stores Dry Cleaners Education Elected Officials Entertainment Event Planning Executive Training Financial & Investment Services Fishing Fitness Florists Food & Beverage/Catering Forestry Fundraising Funeral & Cremation Services Gifts & Specialty Items 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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 Mailing Address Same as physical address Line 1: Line 2: City: State: Postal Code: Country: --- Select Country --- Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bermuda Bhutan Bolivia 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 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 Primary Contact 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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 Billing Contact Information Same as Primary Contact First Name: * Last Name: * Title: Phone: * Cell Phone: Fax: Email: * Contact Preference: Email Phone Login: * Password: * Social Networking: LinkedIn Facebook Address Same as Member Address Line 1: * Line 2 City: * State: * Postal Code: * Country: * --- Select Country --- Canada United States Membership Options Membership Package: * 101 - Diversity and Advisory membership: $0.00 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