Member

“Sustaining Communities By Building One Business at a Time”

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (200 char max):

Directory Category: *

Employees:

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Are you willing to participate on a CBA Committee?:

Are you and/or firm certified with the City of Chicago?:

Are you and/or your firm certified with the State of Illinois?:

Among contracts your business has procured, what is the largest in $.:

What is the date of the largest contract your business has procured:

Among contracts your business has procured, what is the smallest $ amount:

What is the date of the smallest contract your business has procured?:

Are you bonded and insured?:

What is the maximum, of which your business is bonded and insured?:

Please indicate your business need for sustaining and growing your business:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook Twitter Instagram YouTube

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook Twitter Instagram YouTube

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook Twitter Instagram YouTube

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

2024 Corporate Membership New: $1,500.00
New CBA Corporate Member | Consultation of business needs 2024 Corporate Membership Renewal: $1,500.00
2024 CBA Corporate Renewal | Consultation of business needs

Payment Option:

Bill me Charge my credit or debit card

Print Application

Member Application

Mailing Address

Address

Address