Member Application 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 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 South Sudan 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 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 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 South Sudan 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 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... Accountants & CPAs Acupuncture Advertising Advertising & Promotion - Internet Advertising - Internet Advertising - Yellow Pages Afterschool & Camps Air Purification Technology Airport Parking-Valet & Self Service Apartment Rentals Apparel Appliances Arborists Architects Art Classes Art Galleries Art Galleries/Framing Art Studio Arts Management Consulting Asset Protection Assisted Living Communities Athletic Recruitment Attorneys Audio & Video - Dealers Audio/Video Audio/Video Integration Auto Dealerships Automotive - Rentals Automotive Repair Awards, Plaques and Trophies Bakery Bakery & Chocolatier Balance Classes Banking & Mortgages - Reverse Mortgages Banks & Banking Services Banners & Signage Bar & Lounge Barber Barter/Trade Exchange Bday Parties & Events Bicycle Repairs & Accessories Billiards Birthday Parties Bookkeeping Bookkeeping & Administrative Services Bookkeeping Services Bookstore Boutique Branded Apparel Bridal Broadcast Equipment Business Brokers Business Consultants Business Districts Business Education, Workshops, and Webinars Business Forms Business Membership Business Mentoring and Coaching Business Organizations Business Technology Solutions Provider Candy Car Wash Carpeting & Flooring Catering Cemetery Child Care / Development Children's Programs Chiropractors Civil Engineers / Surveyors Cleaners & Laundromats Cleaning Services & Suppliers Closets Clothing Clothing - Formal Rentals Coffee Collection Agencies Commercial Lending Commercial Real Estate Investing & Leasing Communications Computers - Consultants Computers - Internet / Web Computers - Networks Computers - Sales & Service Computers - Sales, Service & Network Integration Computers - Service & Network Integration Computers - Software & Services Computers - Training Conference Planners Conservation Organization Consignment - Clothing & Furnishings Consignment - Furnishings Consultants - Business & Finance Consultants - Culinary Consultants - Education Consultants - Health Care & Staffing Consultants - Lifescience Consultants - Marketing Consultants - Marketing & Financial Consultants - Non-Profits Continuing Care Retirement Community Contractors - Construction Copies and Printing Copywriter Cosmetic & Reconstruction Surgery Cosmetics & Skin Care Counseling Services Country Club COVID Testing COVID Testing CPA Firm Crafts / Art Supplies Credit Union Customer Relationship Management Customized Embroidery Dance Instruction Day Spa Decorative Artist Dementia Assisted Living Dentists Dentists - Periodontists Digital/Online/Print Marketing Agency Distribution Driving School Driving Service Dryer Vent Cleaning E-Commerce E-Commerce Education Education Consulting & College Advising Educational Sales Eldercare Electric Electronics Emotional Health & Well-Being Employment Agencies Employment Recruiter Energy Efficiency Engineering - Electrical Engineering - Environmental Entertainment Estate Sales Event Creation, Marketing & Logistics Event Design & Décor Event Planning Executive and Business Coaching Executive Search Consultant Exporter Family Medicine Fashion Consultants Fences Fencing Academy Financial Services Fine Art Restoration and Conservation Fitness Fitness - Personal Training Flooring Retailer Florists Food Service Packaging Franchising Consultants Fruit and Gourmet Baskets Full Body Stretching Funeral Home, Preplanning, & Cremation Services Funeral Homes Furniture Garage Doors & Openers Garden Center Gifts Golf - Indoor Facility Golf Course Gourmet Specialty Foods & Catering Graphic Design Graphics + Custom Printing & Apparel Graphics + Custom Printing & Apparel Groceries Hair Salons Health & Beauty Health & Wellness Health Care Health Clubs Heating & Cooling Installation Heating / Fuel Hobbies Holistic Health Center Holistic Occupational Therapy Home Cleaning Home Cleaning Products Home Health Care Home Inspections Home Organization Home Security Home Security & Smart Homes Home Staging Hospice Care Hospitals Hotels, Motels, Inns House Sitting HR Consultant Hypnotherapy Ice Creams & Frozen Yogurts Importer Incentives and Awards Individuals Insurance Insurance - Health Insurance - Health Plans Insurance - Life, Health, P & C Integrative Health Interior Design Interior Design & Staging Internal Medicine Internet Marketing Investments Janitorial Services Jewelers Jewelry - Wholesale Junk Removal Services Kitchen Supplies & Bakeware Kitchen, Bathroom & Home Design and Remodel Knitting and Yarn Supplies Laboratory - Medical Diagnostics Land Surveying Landscape Design Landscape Design & Installation Landscapers, Lawn & Tree Care Laser Tag Leads Group I members Leads Group II members Libraries Lighting & Fixtures Lighting Solutions Limousine Service Liquor & Wine Local Marketplace Mailing Services Manufacturing Market Research Consulting Firm Marketing - Video Production Marketing Creative Services Martial Arts Studio Massage Massage Therapy Centers Meal Facilitation Media Services Medical Device Distributors Medical Equipment Supplies & Training Medical Transportation, Emergency and Non-Emergency Medispa Meditation & Holistic Health Consulting Merchant Services Processing Mobile Device Repair Mortgages Moving & Storage Multimedia Museums Music / Musical Instruments Nature Center Network Security and Support Services Newspapers & Magazines Non Profit Nursing Home/Rehabilitation Nutrition Nutrition Bar Nutritional Counseling Nutritionists Occupational Therapy Office Equipment Office Supplies On-Line Information Resource On-line organizing of critical information On-Line Printing & Mailing Services On-line Resources Optical Shop Organic Beverages Organization Painting Painting - Interior/Deck Paper Products Party Rentals Party Services Pastries, Meats, Deli Payroll Processing Pediatric Therapy Performing Arts Personal Coaching Personal Concierge Personal Concierge Personal Security App Personal Training Services Pest Control Pet Grooming and Pet Health Food Store Pet Services Pet Supplies Pharmaceutical Pharmacy Photographers Physical Therapy Physicians / Specialists Pilates Studio Pizza Restaurant Plastic & Reconstructive Surgery Plastic Surgeon Plumbing and Heating Pools Portable Restrooms Pottery Painting Studio Pottery Studio Power Generators Power Sports - Sales & Service PPE Printing Printing - Commercial Offset Private Investigations Private Wealth Management Promotional Merchandise Property Services Psychiatry Public Relations Publishing Real Estate Real Estate - Appraisers Real Estate - Commercial Real Estate - Developers & Management Reconstructive Surgery Refuse Removal Remediation - Fire, Water, Mold, Puffbacks Remodel and Renovation Rentals Research Services Restaurants & Catering Restaurants - Delivery Service Restaurants - Take Out Retail Retirement Plan Administrator Rewards Platform Search Engine for TV & Radio Secretarial Services Security Services Security Systems Self Defense Senior Living Senior Living Advisors Senior Living Advisors Shipping Services Shower Doors, Glass & Mirrors Shredding - Paper Signs Skilled Nursing Facility & Rehab Center Skin Care Smart Homes Software Developer Software for Real Estate Investors & Developers Spa Special Education Specialty Foods Speech Therapists Sports & Swim Activities Sports Facility Sports Nutrition Sports Teams Storage Centers Storefronts and Glass Railings Supermarket Tattoo Studio/Fine Art Gallery Tax Preparation Tea Shop Telecommunications Television Production Company Theater/Entertainment Travel & Tourism Urgent Care Center Utilities Veterinarians Video Production Services Vision Care Walk-ins Daily Web Design Welcome Service Wireless Communications Women's Health & Gynecology Workspace Yacht Club Yoga Full-time Employees * Please add your number of full-time employees. Part-time Employees * Please add your number of part-time employees. Family-Owned Business Choose... Yes No Year Established Non-Profit Tax Status: Is business a 501(c)(3)? * Choose... Yes No Looks good! Step 3: Primary Contact First Name * Please add your first name. Last Name * Please add your last name. Title 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 Address line 2 Country Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize 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 South Sudan 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 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: Billing Contact Same as Primary Contact First Name * Please add your first name. Last Name * Please add your last name. Title 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 Address line 2 Country Choose... Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize 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 South Sudan 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 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 5: Membership Package Please select a Membership Package Micro-Enterprise $ 314 Staff of 1 (including owners) Small Business 2-7 $ 393 Staff of 2-7 (including owners) Small Business 8-13 $ 525 Staff of 8-13 (including owners) Small Business 14-19 $ 655 Staff of 14-19 (including owners) Small Business 20-29 $ 785 Staff of 20-29 (including owners) Small Business 30-39 $ 1,036 Staff of 30-39 (including owners) Small Business 40-49 $ 1,217 Staff of 40-49 (including owners) Business & Industry $ 1,494 Staff of 50-99 (including owners) Business & Industry 100+ $ 2,357 Staff of 100 or more (including owners). Real Estate Agent $ 190 Banks $ 740 Based on total number of branches within the town of Fairfield. The per branch fee is $675. Additional Fees: One-Time Processing Fee $35 one time Administration Processing for New Members Additional Options: FELO Membership $50 one time FELO (Fairfield Emerging Leaders Organization) Annual Membership Fee Payment Option Charge my credit or debit card Please complete the Captcha Back Next Submit Application Print Application