Membership Application

 

Click here to join World Trade Center Delaware now and start taking advantage of the many benefits of being a part of our community! 

   
Organization Information (to be displayed online)
Organization Name *
Address 1 *
Address 2
City *
State *
Zip *
Phone *
Fax
Website
Email *
Briefly describe your company/business *
In which countries are you currently doing business? *
In which countries are you interested in expanding or developing new business? *
Based on your current status, how can WTC Delaware best be of service to your company? *
Would you like to be included on our email mailing list? *
Main Contact
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Zip *
Title
Phone *
Email *
Additional Contacts
Billing Address (if different)
Street
City
State
Zip
Mailing Address (if different)
Street
City
State
Zip
Additional Information
Referred by
How did you hear about us?
What is your reason for joining?
Please have someone contact me regarding
*Check all that apply
Export/Import Consulting
Educational Seminars
Regional Business Roundtables
Customized Research
Referral Network
Other           
Membership Investment
Membership Type: *
Primary Directory Category *
Additional Directory Categories
**Hold CTRL on your keyboard to select multiple categories**
**We are charging $5 for each additional category after 4.

Number of Full Time Employees:  
Number of Part Time Employees:  
   
Total: $ 

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
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
tempValueForDropDown1
Number of Rooms (Accommodations):  
Number of Seats (Restaurants):  
Number of Associates (Realtors, Attorneys):  
Number of Locations ($35/add. location):  
Millions in Assets (Financial Institutions):  
Enhanced Membership ($50):
$ 
$ 
$ 
*
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information
Credit Card Type *
Credit Card Number * 
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
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