Member

Welcome and thank you for applying for membership in Greater Fort Wayne Inc. All membership applications are subject to approval.

Annual membership dues include $20 for a one-year subscription to the Greater Fort Wayne Business Weekly. Greater Today magazine runs as an insert in the Business Weekly every other month.

Business Information

Company Name: *

Phone: *

Website:

Email: *

Business Description (200 char max):

Business Category: *

Employees: *

Full-time Part-time

Business Keywords:

Keyword 1 Keyword 2 Keyword 3 Keyword 4 Keyword 5 Keyword 6 Keyword 7 Keyword 8

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State / Province:

ZIP / Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

Zip / Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Contact Preference:

Email Phone

Password:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

ZIP / Postal Code:

Country:

Membership Options

Membership Package: *

General Business Firm: See fee schedule to determine the fee and enter it below.
General Business Firms Professional Firms: See fee schedule to determine the fee and enter it below.
Professional Firms Non-profit Organization 1-50 employees: $360.00
1-50 employees Non-profit Organization 51-200 employees: $540.00
51-200 employees Non-profit Organization 201+ employees: $1,040.00
201+ employees If using fee schedule, enter fee here:

Additional Fees:

$25 Application fee
One time membership application fee

Payment Option:

Charge my credit card

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 7 plus 6?: *

Print Application

Member Application

Physical Address

Mailing Address

Address

Address