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if (selectedDiscountId) { var discount = promoDiscounts[selectedDiscountId]; if ( (discount.IsStdPkgID && discount.PkgID != 0 && discount.PkgID != selectedPkgId) || (!discount.IsStdPkgID && (selectedAddonIds.length == 0 || (discount.PkgID != 0 && !selectedAddonIds.includes(discount.PkgID))) )) clearPromoCode(); } } else { $('#promosection').hide(); clearPromoCode(); } }); $('.apply-btn').click(function () { var promoCode = $('input[name="NewMemberInfo.PromoCode"]').val().trim().toLowerCase(); if (promoCode) { var hashed = CryptoJS.MD5(promoCode).toString(); var discountid = promoCodes[hashed]; if (discountid) { var discount = promoDiscounts[discountid]; var selectedPkgId = parseInt($('input[name="NewMemberInfo.MemberAppPkg"]:checked').val()); var selectedAddonIds = $('input[name = "NewMemberInfo.AddOns"]:checked').map(function () { return parseInt($(this).val()); }).get(); if ((discount.IsStdPkgID && (discount.PkgID == 0 || selectedPkgId == discount.PkgID) || (!discount.IsStdPkgID && ((selectedAddonIds.length > 0 && discount.PkgID == 0) || selectedAddonIds.includes(discount.PkgID))))) { $('#promocodemsg').text("Promo Code has been successfully applied").attr('class', 'valid-feedback').show(); } else { discountid = ""; $('#promocodemsg').text("Promo Code is invalid for selected item(s)").attr('class', 'invalid-feedback').show(); } } else { discountid = ""; $('#promocodemsg').text("The entered Promo Code is invalid").attr('class', 'invalid-feedback').show(); } } else { $('#promocodemsg').text("").attr('class', 'valid-feedback').hide(); } $('input[name="NewMemberInfo.PromoDiscountID"]').val(discountid); }); $('input[name="NewMemberInfo.PromoCode"]').keyup(function () { $('input[name="NewMemberInfo.PromoDiscountID"]').val(""); if ($('input[name="NewMemberInfo.PromoCode"]').val().trim().length > 0) { $('#promocodemsg').text("You must click apply to validate and use code").attr('class', 'invalid-feedback').show(); } else { $('#promocodemsg').text("").attr('class', 'valid-feedback').hide(); } }); function scrollToTop() { $('html, body').animate({ scrollTop: $('#gzns').offset().top }, 500, 'linear'); } function updateSteps() { var steps = [1, 2, 3, 4, 5].reduce(function (o, k) { o[k] = !$('#step' + k + ' :invalid').length; return o; }, {}); Object.keys(steps).forEach(function (step) { $('.gz-app-step.step-' + step) .addClass(steps[step] ? 'valid':'invalid') .removeClass(steps[step] ? 'invalid':'valid'); }); var firstInvalid = Object.keys(steps).filter(function (step) { return !steps[step] })[0] || 1; if ($('#AppFormSameAsM').length && $('#AppFormSameAsM').prop('checked')) { $('#AppFormSameAsM').trigger("click"); if (!$('.gz-primary-address .invalid-feedback:visible').length) { $('#AppFormSameAsM').trigger("click"); } } $wrapper.attr("step", firstInvalid); scrollToTop(); } function goTo($button, scroll) { var step = $button.data('step'); if (step) $wrapper.attr("step", step); else { step = Number($wrapper.attr("step")); if ($button.hasClass('gz-next-btn')) { $wrapper.attr("step", step+1); } else { $wrapper.attr("step", step-1); } } if (scroll) scrollToTop(); } function copyFrom($src, fields) { return function ($dest) { fields.forEach(function (c) { $dest.find('.' + c + ' input').val($src.find('.' + c + ' input').val()); }); } } function copySocialFrom($src) { return function ($dest) { $dest.find('.gz-social').each(function () { var destId = $(this).find('input').attr('id') var srcId = destId.replace('BillRepSocialNetworkID', 'PriRepSocialNetworkID') $dest.find('#' + destId).val($src.find('#' + srcId).val()); }); } } function copyStateFrom($src) { return function ($dest) { var visibleState = $src.find('.gz-state div:visible'); $dest.find('.gz-country select').val($src.find('.gz-country select').val()).trigger('change'); if (visibleState.hasClass('state-drop')) { $dest.find('.state-drop select').val($src.find('.state-drop select').val()); } else if (visibleState.hasClass('province-drop')) { $dest.find('.province-drop select').val($src.find('.province-drop select').val()); } else { $dest.find('.state-field input').val($src.find('.state-field input').val()); } } } function copyAddressTo($dest) { copyFrom($('.gz-physical-address'), ['gz-address-1', 'gz-address-2', 'gz-city', 'gz-zip', 'gz-country'])($dest) copyStateFrom($('.gz-physical-address'))($dest) } function copyRepTo($dest) { copyFrom($('.gz-primary-group'), ['gz-first-name', 'gz-last-name', 'gz-title', 'gz-phone', 'gz-cell', 'gz-fax', 'gz-email', 'gz-contact-pref', 'gz-login', 'gz-pass'])($dest) copySocialFrom($('.gz-step3-socialli'))($dest) } function copyRepAddrTo($dest) { copyFrom($('.gz-primary-address'), ['gz-address-1', 'gz-address-2', 'gz-city', 'gz-zip', 'gz-country'])($dest) if ($('.gz-primary-address').find('.gz-state div:visible').length == 0) copyStateFrom($('.gz-physical-address'))($dest) else copyStateFrom($('.gz-primary-address'))($dest) } $form.find('input[name*="cf_"]').click(function () { var $this = $(this); var name = $this.prop('name'); if ($this.prop('checked')) { $('input[type="hidden"][name="' + name + '"]').prop('disabled', true); } else { $('input[type="hidden"][name="' + name + '"]').prop('disabled', false); } }); $form.find('a.submit-btn').click(function (e) { e.preventDefault(); $form.find('.gz-is-inherited').each(function () { var $this = $(this); if ($this.hasClass('gz-address-fields')) { if ($this.hasClass('gz-billing-address')) copyRepAddrTo($this) else copyAddressTo($this); } else copyRepTo($this); }); if (form.checkValidity() === false) { form.classList.add('was-validated'); updateSteps(); } else { var selectedPkgIsMonthly = $form.find('input[type="radio"][name="NewMemberInfo.MemberAppPkg"]:checked').data('is-monthly'); $form.find('#SwitchedToMonthly').val(selectedPkgIsMonthly == 1); form.submit(); } }); $form.find(".gz-app-transition").click(function (e) { e.preventDefault(); goTo($(this), $(this).hasClass('btn')); }); $form.find('input[type="radio"][name="NewMemberInfo.MemberAppPkg"]').change(function () { var $this = $(this); var currItemId = "AppFeeAmt" + this.value; $('input[name="NewMemberInfo.MembershipPackageFee"]').removeAttr("required"); $('input[name="NewMemberInfo.MembershipPackageFee"]').each(function () { if (this.id != currItemId) $(this).prop('disabled', true); else $(this).prop('disabled', false); }); $('#AppFeeAmt' + this.value).attr("required", ""); $('[data-application-package="true"]').removeAttr("required"); if ($this.data('is-monthly') == "1") { $form.find('.bill-me-option').hide(); $form.find('#AppFormPymnt2').prop("checked", "checked"); } else { $form.find('.bill-me-option').show(); } }); $form.find('#privacyModal button.success').click(function () { $form.find('#gz-privacy-policy-chk').prop('checked', true); }) $form.find('.gz-login-creation input').each(function () { var $this = $(this); var $login = $('[name="NewMemberInfo.' + $this.data('login') + '"]'); var $pwd = $('[name="NewMemberInfo.' + $this.data('pwd') + '"]'); [$login, $pwd].forEach(function ($input) { $input.blur(function () { if ($login.val().trim() || $pwd.val().trim()) { $this.attr("required",""); $.ajax({ url: MNI.BaseUrl + '/member/accountavailability', data: { username: $login.val(), password: $pwd.val() }, type: 'POST' }).then(function (data) { $this.val(data.Verified ? "OK" : ""); $this[0].checkValidity(); }); } else { $this.removeAttr("required"); $this.val(""); $this[0].checkValidity(); } }); }) }); $form.find('.gz-same-as-above input').change(function () { var $this = $(this); var $group = $this.parents('.gz-inherited-fields'); if ($this[0].id == "AppBillSameAsMA") { $group = $('.gz-address-fields'); } if ($this.prop('checked')) { $group.addClass('gz-is-inherited'); if ($this[0].id == "AppFormSameAsPC") { $('#AppBillSameAsMA').parent().parent().hide(); } } else { $group.removeClass('gz-is-inherited'); if ($this[0].id == "AppFormSameAsPC") { $('#AppBillSameAsMA').parent().parent().show(); } } }) $form.find('.switch-frequency').click(function (e) { e.preventDefault(); var switchlink = $(this); var elemAmount = switchlink.closest('.fee-item-wrapper').find('.fee-item-amount'); var elemFreq = switchlink.closest('.fee-item-wrapper').find('.fee-item-freq'); var pkgOption = 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Calendar</span></a></li> <li id="menu-item-759" class="menu-item menu-item-type-custom menu-item-object-custom uabb-creative-menu uabb-cm-style"><a href="https://business.portageinchamber.com/events/"><span class="menu-item-text">Events Listing</span></a></li> <li id="menu-item-1108" class="menu-item menu-item-type-post_type menu-item-object-page uabb-creative-menu uabb-cm-style"><a href="https://portageinchamber.com/event-gallery/"><span class="menu-item-text">Event Gallery</span></a></li> </ul> </li> <li id="menu-item-4047" class="menu-item menu-item-type-custom menu-item-object-custom uabb-creative-menu uabb-cm-style"><a href="https://business.portageinchamber.com/news/"><span class="menu-item-text">News</span></a></li> <li id="menu-item-3428" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-has-children uabb-has-submenu uabb-creative-menu uabb-cm-style" aria-haspopup="true"><div class="uabb-has-submenu-container"><a href="https://portageinchamber.com/explore-portage/"><span class="menu-item-text">Portage Perks<span class="uabb-menu-toggle"></span></span></a></div> <ul class="sub-menu"> <li id="menu-item-755" class="menu-item menu-item-type-custom menu-item-object-custom uabb-creative-menu uabb-cm-style"><a href="https://business.portageinchamber.com/hotdeals/"><span class="menu-item-text">Hot Deals</span></a></li> <li id="menu-item-349" class="menu-item menu-item-type-post_type menu-item-object-page uabb-creative-menu uabb-cm-style"><a href="https://portageinchamber.com/explore-portage/"><span class="menu-item-text">Explore Portage</span></a></li> <li id="menu-item-3431" class="menu-item menu-item-type-custom menu-item-object-custom uabb-creative-menu uabb-cm-style"><a href="#location"><span class="menu-item-text">Location</span></a></li> </ul> </li> <li id="menu-item-767" class="menu-item menu-item-type-custom menu-item-object-custom uabb-creative-menu uabb-cm-style"><a href="https://business.portageinchamber.com/contact/"><span class="menu-item-text">Contact</span></a></li> </ul> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="fl-row fl-row-full-width fl-row-bg-color fl-node-5d1b5922d2a01 fl-row-default-height fl-row-align-center" data-node="5d1b5922d2a01"> <div class="fl-row-content-wrap"> <div class="uabb-row-separator uabb-top-row-separator" > </div> <div class="fl-row-content fl-row-fixed-width fl-node-content"> <div class="fl-col-group fl-node-5d1b5922d7f24" data-node="5d1b5922d7f24"> <div class="fl-col fl-node-5d1b5922d817b fl-col-bg-color" data-node="5d1b5922d817b"> <div class="fl-col-content fl-node-content"><div class="fl-module fl-module-heading fl-node-5d1b5922d1fd9" data-node="5d1b5922d1fd9"> <div class="fl-module-content fl-node-content"> <h1 class="fl-heading"> <span class="fl-heading-text">Member Application</span> </h1> </div> </div> </div> </div> </div> </div> </div> </div> </header><div class="uabb-js-breakpoint" style="display: none;"></div> <div id="fl-main-content" class="fl-page-content" itemprop="mainContentOfPage" role="main"> <div class="fl-content-full container"> <div class="row"> <div class="fl-content col-md-12"> <article class="fl-post post-749 page type-page status-publish hentry" id="fl-post-749" itemscope="itemscope" itemtype="https://schema.org/CreativeWork"> <div class="fl-post-content clearfix" itemprop="text"> <div class="fl-builder-content fl-builder-content-749 fl-builder-content-primary fl-builder-global-templates-locked" data-post-id="749"><div class="fl-row fl-row-full-width fl-row-bg-none fl-node-5d1b6a7b0cbf2 fl-row-default-height fl-row-align-center" data-node="5d1b6a7b0cbf2"> <div class="fl-row-content-wrap"> <div class="uabb-row-separator uabb-top-row-separator" > </div> <div class="fl-row-content fl-row-fixed-width fl-node-content"> <div class="fl-col-group fl-node-5d1b6a7b0e68b" data-node="5d1b6a7b0e68b"> <div class="fl-col fl-node-5d1b6a7b0e7d5 fl-col-bg-color" data-node="5d1b6a7b0e7d5"> <div class="fl-col-content fl-node-content"><div class="fl-module fl-module-rich-text fl-node-5d1b6a7b105fd" data-node="5d1b6a7b105fd"> <div class="fl-module-content fl-node-content"> <div class="fl-rich-text"> <p> <div id="gzns">   <div class="container-fluid gz-memberapp">  <div class="d-flex w-100 gz-pagetitle-dealsbuttons"> <div class="gz-dealsbuttons"></div> </div>  <div class="row gz-intro-paragraph"> <div class="col">Do something good for your business and the greater community; join The Portage Chamber of Commerce today! We thank you for your interest, and remind you that Your Business is Our Only Business!聽 All online memberships require credit card payment and a $35 application fee due at the time of sign-up. If you need to be invoiced, please contact the Chamber at (219) 762-3300. <br><br> Non Profit? Give us a Call at (219) 762-3300 or <a href="https://portageinchamber.com/wp-content/uploads/2024/05/2024-Non-Profit-Charity-Member-Application.pdf" target="_blank">Download the Non Profit Application</a>!</div> </div>   <div class="row gz-memberapp-form initial" step="1" last-step="5"> <div class="col"> <form action="https://business.portageinchamber.com/member/newmemberapp" class="needs-validation" method="post" name="NewMemberApp" novalidate=""> <input type="hidden" name="NewMemberInfo.AtomicGUID" value="491bab57-748f-44f8-86b4-d34f8cb1135e" />  <div id="AppStepper" class="list-group flex-row gz-app-stepper"> <a class="list-group-item flex-fill gz-app-step gz-app-transition step-1" data-step="1" href="#"> <span class="gz-fa-stack gz-fa-2x"> <i class="gz-fa gz-fa-circle gz-fa-stack-2x icon-background"></i> <i class="gz-fab gz-fa-wpforms gz-fa-stack-1x icon"></i> </span> <div class="gz-step">Step 1: <span class="gz-step1-text">Member Info</span></div> </a> <a class="list-group-item flex-fill gz-app-step gz-app-transition step-2" data-step="2" href="#"> <span class="gz-fa-stack gz-fa-2x add"> <i class="gz-fa gz-fa-circle gz-fa-stack-2x icon-background"></i> <i class="gz-fab gz-fa-wpforms gz-fa-stack-1x icon"></i> </span> <div class="gz-step">Step 2: <span class="gz-step2-text">Additional Info</span></div> </a> <a class="list-group-item flex-fill gz-app-step gz-app-transition step-3" data-step="3" href="#"> <span class="gz-fa-stack gz-fa-2x prim"> <i class="gz-fa gz-fa-circle gz-fa-stack-2x icon-background"></i> <i class="gz-fas gz-fa-user-alt gz-fa-stack-1x icon"></i> </span> <div class="gz-step">Step 3: <span class="gz-step3-text">Primary Contact</span></div> </a> <a class="list-group-item flex-fill gz-app-step gz-app-transition step-4" data-step="4" href="#"> <span class="gz-fa-stack gz-fa-2x bill"> <i class="gz-fa gz-fa-circle gz-fa-stack-2x icon-background"></i> <i class="gz-fas gz-fa-user-alt gz-fa-stack-1x icon"></i> </span> <div class="gz-step">Step 4: <span class="gz-step4-text">Billing Contact</span></div> </a> <a class="list-group-item flex-fill gz-app-step gz-app-transition step-5" data-step="5" href="#"> <span class="gz-fa-stack gz-fa-2x"> <i class="gz-fa gz-fa-circle gz-fa-stack-2x icon-background"></i> <i class="gz-far gz-fa-handshake gz-fa-stack-1x icon"></i> </span> <div class="gz-step">Step 5: <span class="gz-step5-text">Membership Options</span></div> </a> </div>  <div class="form-row gz-memberapp-step" data-step="1" id="step1"> <div class="col-12 gz-step1-title"> <h3 class="gz-subtitle">Step 1:</h3> </div> <div class="col-12 gz-step1-applabel"> <h5 class="gz-subtitle">Member Info</h5> </div> <div class="form-group col-12 gz-step1-Coname"> <label for="AppFormOrganization">Company Name <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormOrganization" name="NewMemberInfo.MemCompanyName" placeholder="Company, Inc." required="" type="text" value="" /> <div class="invalid-feedback"> Please add your company name. </div> </div> <div class="form-group col-12 gz-step1-Blank" style="display:none"> <label for="AppFormBlank">Leave Blank</label> <input class="form-control" id="AppFormBlank" name="NewMemberInfo.AlternateEmail" type="text" autocomplete="off"/> </div> <div class="form-group col-6 col-md-4 gz-step1-phone"> <label for="AppFormBusPhone">Phone <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBusPhone" name="NewMemberInfo.MemPhone" placeholder="(000) 000-0000" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your company phone number. </div> </div> <div class="form-group col-6 col-md-4 gz-step1-web"> <label for="AppFormBusWeb">Website <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBusWeb" name="NewMemberInfo.MemWebSite" placeholder="www.example.com" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your company website. </div> </div> <div class="form-group col-6 col-md-4 gz-step1-email"> <label for="AppFormBusEmail">Email <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBusEmail" name="NewMemberInfo.MemEMail" pattern="^[a-zA-Z0-9._-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,62}$" placeholder="info@example.com" required="" type="text" value="" /> <div class="invalid-feedback"> Please add a valid email. </div> </div>  <div class="col-12 gz-step1-phaddlabel"> <h5 class="gz-subtitle">Physical Address</h5> </div> <div class="col-12 gz-address-fields gz-physical-address"> <div class="form-row"> <div class="form-group col-12 col-sm-6 gz-step1-add1 gz-address-1"> <label for="AppFormAddBus1">Address line 1 </label> <input class="form-control" id="AppFormAddBus1" name="NewMemberInfo.MemPhysAdrs1" placeholder="123 Example Street" type="text" value="" /> </div> <div class="form-group col-12 col-sm-6 gz-step1-add2 gz-address-2"> <label for="AppFormAddBus2">Address line 2 </label> <input class="form-control" id="AppFormAddBus2" name="NewMemberInfo.MemPhysAdrs2" placeholder="Suite 900" type="text" value="" /> </div> <div class="form-group col-6 col-sm-3 gz-step1-country gz-country"> <label for="AppFormBusCountry">Country </label> <select class="form-control" id="AppFormBusCountry" name="NewMemberInfo.MemPhysCountry"><option value="">Choose...</option> <option value="AF">Afghanistan</option> <option value="AL">Albania</option> <option value="DZ">Algeria</option> <option value="AR">Argentina</option> <option value="AM">Armenia</option> <option value="AU">Australia</option> <option value="AT">Austria</option> <option value="AZ">Azerbaijan</option> <option value="BS">Bahamas</option> <option value="BH">Bahrain</option> <option value="BD">Bangladesh</option> <option value="BE">Belgium</option> <option value="BZ">Belize</option> <option value="BM">Bermuda</option> <option value="BM">Bermuda</option> <option value="BT">Bhutan</option> <option value="BO">Bolivia</option> <option value="BA">Bosnia and Herzegovina</option> <option value="BW">Botswana</option> <option value="BR">Brazil</option> <option value="VG">British Virgin Islands</option> <option value="BN">Brunei</option> <option value="BG">Bulgaria</option> <option value="KH">Cambodia</option> <option value="CM">Cameroon</option> <option value="CA">Canada</option> <option value="029">Caribbean</option> <option value="CL">Chile</option> <option value="CN">China</option> <option value="CO">Colombia</option> <option value="CD">Congo (DRC)</option> <option value="CR">Costa Rica</option> <option value="CI">Côte d鈥橧voire</option> <option value="HR">Croatia</option> <option value="CU">Cuba</option> <option value="CZ">Czechia</option> <option value="DK">Denmark</option> <option value="DO">Dominican Republic</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="FO">Faroe Islands</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GT">Guatemala</option> <option value="HT">Haiti</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong SAR</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IE">Ireland</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KR">Korea</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Laos</option> <option value="419">Latin America</option> <option value="LV">Latvia</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao SAR</option> <option value="MK">Macedonia, FYRO</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MX">Mexico</option> <option value="MD">Moldova</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="ME">Montenegro</option> <option value="MA">Morocco</option> <option value="MM">Myanmar</option> <option value="NP">Nepal</option> <option value="NL">Netherlands</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NG">Nigeria</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PA">Panama</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="RE">Réunion</option> <option value="RO">Romania</option> <option value="RU">Russia</option> <option value="RW">Rwanda</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="RS">Serbia</option> <option value="SG">Singapore</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SO">Somalia</option> <option value="ZA">South Africa</option> <option value="ES">Spain</option> <option value="LK">Sri Lanka</option> <option value="SE">Sweden</option> <option value="CH">Switzerland</option> <option value="TW">Taiwan</option> <option value="TJ">Tajikistan</option> <option value="TH">Thailand</option> <option value="TT">Trinidad and Tobago</option> <option value="TN">Tunisia</option> <option value="TR">Türkiye</option> <option value="TM">Turkmenistan</option> <option value="UA">Ukraine</option> <option value="AE">United Arab Emirates</option> <option value="GB">United Kingdom</option> <option selected="selected" value="US">United States</option> <option value="UY">Uruguay</option> <option value="UZ">Uzbekistan</option> <option value="VE">Venezuela</option> <option value="VN">Vietnam</option> <option value="001">World</option> <option value="YE">Yemen</option> </select> </div> <div class="form-group col-6 col-sm-3 gz-step1-city gz-city"> <label for="AppFormBusCity">City </label> <input class="form-control" id="AppFormBusCity" name="NewMemberInfo.MemPhysCity" placeholder="Orlando" type="text" value="" /> </div> <div class="form-group col-6 col-sm-3 gz-step1-state gz-state"> <div class="state-drop" style="display: none;"> <label for="AppFormBusStateDrop">State </label> <select class="form-control" id="AppFormBusStateDrop" name="NewMemberInfo.MemPhysState"><option value="">Choose...</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FM">Federated States of Micronesia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="MP">Northern Mariana Islands</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VI">Virgin Islands</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> </div> <div class="province-drop" style="display: none;"> <label for="AppFormBusProvinceDrop">State </label> <select class="form-control" id="AppFormBusProvinceDrop" name="NewMemberInfo.MemPhysState"><option value="">Choose...</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NT">Northwest Territories</option> <option value="NS">Nova Scotia</option> <option value="NU">Nunavut</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon</option> </select> </div> <div class="state-field"> <label for="AppFormBusState">State </label> <input class="form-control" id="AppFormBusState" name="NewMemberInfo.MemPhysState" placeholder="MN" type="text" value="" /> </div> </div> <div class="form-group col-6 col-sm-3 gz-step1-zip gz-zip"> <label for="AppFormBusZip">Postal Code </label> <input class="form-control" id="AppFormBusZip" name="NewMemberInfo.MemPhysZip" placeholder="54321" type="text" value="" /> </div> </div> </div> <div class="col-12 gz-step1-mladdlabel"> <h5 class="gz-subtitle">Mailing Address</h5> </div> <div class="col-12 gz-address-fields gz-inherited-fields gz-is-inherited"> <div class="form-row"> <div class="form-group col-12 gz-step1-sameas gz-same-as-above"> <div class="form-check checkbox-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppFormSameAsP" name="NewMemberInfo.MemMailAdrsIsPhysAdrs" type="checkbox" value="true" /><input name="NewMemberInfo.MemMailAdrsIsPhysAdrs" type="hidden" value="false" /> <label class="form-check-label" for="AppFormSameAsP">Same as physical address</label> </div> </div> <div class="form-group col-12 col-sm-6 gz-step1-mladd1 gz-address-1"> <label for="AppFormAddMailBus1">Address line 1 <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormAddMailBus1" name="NewMemberInfo.MemMailAdrs1" placeholder="123 Example Street" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your address. </div> </div> <div class="form-group col-12 col-sm-6 gz-step1-mladd2 gz-address-2"> <label for="AppFormAddMailBus2">Address line 2 </label> <input class="form-control" id="AppFormAddMailBus2" name="NewMemberInfo.MemMailAdrs2" placeholder="Suite 900" type="text" value="" /> </div> <div class="form-group col-6 col-sm-3 gz-step1-mlcountry gz-country"> <label for="AppFormMailBusCountry">Country <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormMailBusCountry" name="NewMemberInfo.MemMailCountry" required=""><option value="">Choose...</option> <option value="AF">Afghanistan</option> <option value="AL">Albania</option> <option value="DZ">Algeria</option> <option value="AR">Argentina</option> <option value="AM">Armenia</option> <option value="AU">Australia</option> <option value="AT">Austria</option> <option value="AZ">Azerbaijan</option> <option value="BS">Bahamas</option> <option value="BH">Bahrain</option> <option value="BD">Bangladesh</option> <option value="BE">Belgium</option> <option value="BZ">Belize</option> <option value="BM">Bermuda</option> <option value="BM">Bermuda</option> <option value="BT">Bhutan</option> <option value="BO">Bolivia</option> <option value="BA">Bosnia and Herzegovina</option> <option value="BW">Botswana</option> <option value="BR">Brazil</option> <option value="VG">British Virgin Islands</option> <option value="BN">Brunei</option> <option value="BG">Bulgaria</option> <option value="KH">Cambodia</option> <option value="CM">Cameroon</option> <option value="CA">Canada</option> <option value="029">Caribbean</option> <option value="CL">Chile</option> <option value="CN">China</option> <option value="CO">Colombia</option> <option value="CD">Congo (DRC)</option> <option value="CR">Costa Rica</option> <option value="CI">Côte d鈥橧voire</option> <option value="HR">Croatia</option> <option value="CU">Cuba</option> <option value="CZ">Czechia</option> <option value="DK">Denmark</option> <option value="DO">Dominican Republic</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="FO">Faroe Islands</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GT">Guatemala</option> <option value="HT">Haiti</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong SAR</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IE">Ireland</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KR">Korea</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Laos</option> <option value="419">Latin America</option> <option value="LV">Latvia</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao SAR</option> <option value="MK">Macedonia, FYRO</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MX">Mexico</option> <option value="MD">Moldova</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="ME">Montenegro</option> <option value="MA">Morocco</option> <option value="MM">Myanmar</option> <option value="NP">Nepal</option> <option value="NL">Netherlands</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NG">Nigeria</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PA">Panama</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="RE">Réunion</option> <option value="RO">Romania</option> <option value="RU">Russia</option> <option value="RW">Rwanda</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="RS">Serbia</option> <option value="SG">Singapore</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SO">Somalia</option> <option value="ZA">South Africa</option> <option value="ES">Spain</option> <option value="LK">Sri Lanka</option> <option value="SE">Sweden</option> <option value="CH">Switzerland</option> <option value="TW">Taiwan</option> <option value="TJ">Tajikistan</option> <option value="TH">Thailand</option> <option value="TT">Trinidad and Tobago</option> <option value="TN">Tunisia</option> <option value="TR">Türkiye</option> <option value="TM">Turkmenistan</option> <option value="UA">Ukraine</option> <option value="AE">United Arab Emirates</option> <option value="GB">United Kingdom</option> <option selected="selected" value="US">United States</option> <option value="UY">Uruguay</option> <option value="UZ">Uzbekistan</option> <option value="VE">Venezuela</option> <option value="VN">Vietnam</option> <option value="001">World</option> <option value="YE">Yemen</option> </select> <div class="invalid-feedback"> Please add your country. </div> </div> <div class="form-group col-6 col-sm-3 gz-step1-mlcity gz-city"> <label for="AppFormMailBusCity">City <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormMailBusCity" name="NewMemberInfo.MemMailCity" placeholder="Orlando" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your City. </div> </div> <div class="form-group col-6 col-sm-3 gz-step1-mlstate gz-state"> <div class="state-drop" style="display: none;"> <label for="AppFormMailBusStateDrop">State <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormMailBusStateDrop" name="NewMemberInfo.MemMailState" required=""><option value="">Choose...</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FM">Federated States of Micronesia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="MP">Northern Mariana Islands</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VI">Virgin Islands</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> <div class="invalid-feedback"> Please add your State. </div> </div> <div class="province-drop" style="display: none;"> <label for="AppFormMailBusProvinceDrop">State </label> <select class="form-control" id="AppFormMailBusProvinceDrop" name="NewMemberInfo.MemMailState"><option value="">Choose...</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NT">Northwest Territories</option> <option value="NS">Nova Scotia</option> <option value="NU">Nunavut</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon</option> </select> </div> <div class="state-field"> <label for="AppFormMailBusState">State <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormMailBusState" name="NewMemberInfo.MemMailState" placeholder="MN" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your State. </div> </div> </div> <div class="form-group col-6 col-sm-3 gz-step1-mlzip gz-zip"> <label for="AppFormMailBusZip">Postal Code <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormMailBusZip" name="NewMemberInfo.MemMailZip" placeholder="54321" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your Postal Code. </div> </div> </div> </div> <div class="col-12 gz-step1-sociallabel"> <h5 class="gz-subtitle">Social Network Addresses</h5> </div> <div class="form-group col-6 col-md-4 gz-step1-socialli"> <label for="MbrSocialNetworkID_1">LinkedIn </label> <input type="text" class="form-control" name="MbrSocialNetworkID_1" id="MbrSocialNetworkID_1" placeholder="https://linkedin.com"> </div> <div class="form-group col-6 col-md-4 gz-step1-socialli"> <label for="MbrSocialNetworkID_2">Facebook </label> <input type="text" class="form-control" name="MbrSocialNetworkID_2" id="MbrSocialNetworkID_2" placeholder="https://facebook.com"> </div> <div class="form-group col-6 col-md-4 gz-step1-socialli"> <label for="MbrSocialNetworkID_3">Instagram </label> <input type="text" class="form-control" name="MbrSocialNetworkID_3" id="MbrSocialNetworkID_3" placeholder="https://instagram.com"> </div> <div class="form-group col-6 col-md-4 gz-step1-socialli"> <label for="MbrSocialNetworkID_11">X </label> <input type="text" class="form-control" name="MbrSocialNetworkID_11" id="MbrSocialNetworkID_11" placeholder="https://x.com"> </div> <div class="form-group col-6 col-md-4 gz-step1-socialli"> <label for="MbrSocialNetworkID_5">TikTok </label> <input type="text" class="form-control" name="MbrSocialNetworkID_5" id="MbrSocialNetworkID_5" placeholder="https://tiktok.com"> </div> </div>  <div class="form-row gz-memberapp-step" data-step="2" id="step2"> <div class="col-12 gz-step2-title"> <h3 class="gz-subtitle">Step 2:</h3> </div> <div class="col-12 gz-step2-addlabel"> <h5 class="gz-subtitle">Additional Info</h5> </div> <div class="form-group col-12 gz-step2-bus-desc"> <label for="AppFormBusDesc">Business Description (200 char max) </label> <textarea class="form-control" cols="20" id="AppFormBusDesc" maxlength="200" name="NewMemberInfo.MemFullDesc" placeholder="Type description here." rows="2"> </textarea> </div> <div class="form-group col-12 col-sm-4 gz-step2-dcat"> <label for="AppFormDcat">Directory Category <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormDcat" name="NewMemberInfo.MemBusCatPri" required=""><option value="">Choose...</option> <option value="25">Accounting</option> <option value="1">Advertising/Marketing</option> <option value="194">African American Owned</option> <option value="8">Agriculture</option> <option value="76">Antiques/Estate Sales/Consignments</option> <option value="66">Apartments</option> <option value="21">Architects</option> <option value="11">Art Galleries </option> <option value="195">Asian Owned</option> <option value="12">Asphalt Maintenance</option> <option value="33">Assisted Living</option> <option value="45">Attorneys</option> <option value="15">Automotive</option> <option value="26">Banks </option> <option value="54">Beauty Salons/Spas</option> <option value="77">Books & Stationery</option> <option value="98">Bowling</option> <option value="99">Brake Systems</option> <option value="177">Call Center</option> <option value="100">Campground/RV Park</option> <option value="93">Car Rentals</option> <option value="101">Caregiver</option> <option value="41">Carpets & Interiors</option> <option value="102">Caterers</option> <option value="55">Childcare</option> <option value="78">Childrens Clothing/Toys</option> <option value="34">Chiropractors</option> <option value="70">Churches</option> <option value="104">Cigar Shops</option> <option value="105">Citizen Members</option> <option value="106">City Hall</option> <option value="56">Cleaning Services (Commercial & Residential)</option> <option value="79">Clothing/Shoes</option> <option value="24">Community Organizations</option> <option value="19">Computer Service/Sales</option> <option value="22">Construction Management</option> <option value="17">Consultants</option> <option value="23">Contractors</option> <option value="57">Counseling/Parenting Agencies</option> <option value="89">Country Clubs</option> <option value="190">Credit Card Processing</option> <option value="108">Credit Unions</option> <option value="178">Customer Service</option> <option value="90">Dance</option> <option value="35">Dental/Orthodontist</option> <option value="185">Dog Obedience </option> <option value="80">Drug & Variety Stores</option> <option value="58">Dry Cleaners</option> <option value="109">Economic Development</option> <option value="30">Educational Facilities</option> <option value="31">Elected Officials</option> <option value="110">Employment Services</option> <option value="111">Engineers</option> <option value="187">Engraved Gifts</option> <option value="13">Entertainment</option> <option value="14">Event Planning</option> <option value="112">Farmacologists</option> <option value="27">Financial & Investment Services</option> <option value="9">Fishing</option> <option value="183">Fitness</option> <option value="113">Flooring</option> <option value="81">Florists</option> <option value="71">Food Stores/Retail</option> <option value="10">Forestry</option> <option value="59">Funeral & Cremation Services</option> <option value="114">Furniture</option> <option value="115">Gas/Convenience Stores</option> <option value="82">Gifts/Food Shops</option> <option value="116">Golf Courses & Country Clubs</option> <option value="32">Government</option> <option value="117">Grain Elevator</option> <option value="2">Graphic Design</option> <option value="72">Grocery Stores</option> <option value="118">Guns</option> <option value="119">Hair Salons</option> <option value="83">Hardware</option> <option value="91">Health & Fitness</option> <option value="120">Hearing Services</option> <option value="121">Heating/AC & Refrigeration</option> <option value="122">Heavy Equipment</option> <option value="196">Hispanic or Latino Owned</option> <option value="36">Holistic Health</option> <option value="182">Home Builder</option> <option value="42">Home Furnishings</option> <option value="124">Home Health Care</option> <option value="123">Hospice</option> <option value="37">Hospitals </option> <option value="49">Hotels/Motels</option> <option value="18">Human Resource Services</option> <option value="125">Ice Cream</option> <option value="126">Ice Vendors</option> <option value="28">Insurance</option> <option value="43">Interior Design</option> <option value="127">Internet Service Providers</option> <option value="84">Jewelers</option> <option value="175">Labor Union</option> <option value="44">Landscaping/Lawn Maintenance</option> <option value="46">Legal Services</option> <option value="128">Libraries</option> <option value="130">Limestone</option> <option value="129">Limousine Services</option> <option value="131">Linen Rentals</option> <option value="73">Liquors</option> <option value="85">Mail Services/Shipping</option> <option value="52">Manufacturing & Production</option> <option value="16">Marinas</option> <option value="3">Marketing Services</option> <option value="60">Massage Therapy</option> <option value="38">Media</option> <option value="191">Merchant Services</option> <option value="197">Middle Eastern or North African Owned</option> <option value="29">Mortgage Services</option> <option value="39">Museums</option> <option value="132">Music Studios</option> <option value="198">Native American or Alaska Native Owned</option> <option value="133">Natural Health</option> <option value="134">News</option> <option value="135">Newspapers</option> <option value="192">Not for Profit 501(c)3</option> <option value="181">Notary</option> <option value="136">Nurses</option> <option value="137">Nursing Homes/Assisted Living Facilities</option> <option value="189">Nutrition</option> <option value="86">Office Equipment & Supplies</option> <option value="40">Optical Care</option> <option value="107">Organizations</option> <option value="138">Outdoor Retaier</option> <option value="61">Packaging</option> <option value="139">Paint</option> <option value="140">Painters</option> <option value="188">Painting</option> <option value="141">Party (Retail & Rentals)</option> <option value="142">Pest Control</option> <option value="174">Pet Groomer</option> <option value="63">Pets Supplies</option> <option value="143">Pharmacies</option> <option value="87">Photographers/Photo Finishing/Framing</option> <option value="144">Physicians/Clinics</option> <option value="145">Plumbing</option> <option value="146">Pools & Spas</option> <option value="147">Port Services</option> <option value="4">Press/Publications/Radio</option> <option value="5">Printers</option> <option value="67">Property Maintenance</option> <option value="172">Property Management</option> <option value="148">Psychologists</option> <option value="6">Public Relations</option> <option value="186">Public Service Adjusters</option> <option value="184">Quality Control</option> <option value="68">Real Estate </option> <option value="149">Recreational Vehicles</option> <option value="150">Refractories</option> <option value="152">Rehabilitation Centers</option> <option value="153">Rentals</option> <option value="154">Research & Development</option> <option value="50">Resorts</option> <option value="74">Restaurants</option> <option value="75">Restoration</option> <option value="156">Sanitation</option> <option value="62">Security Services</option> <option value="88">Shopping Centers</option> <option value="7">Signs & Banners</option> <option value="92">Sporting Goods</option> <option value="157">Sports</option> <option value="158">Steel</option> <option value="69">Storage</option> <option value="47">Tax Services</option> <option value="94">Taxi</option> <option value="159">Technology</option> <option value="20">Telecommunications</option> <option value="160">Telephone Systems</option> <option value="161">Television</option> <option value="162">Testing</option> <option value="163">Theaters</option> <option value="164">Tires</option> <option value="48">Title Companies</option> <option value="165">Tools & Equipment</option> <option value="166">Tourism</option> <option value="176">Transportation</option> <option value="51">Travel Agencies</option> <option value="167">Tree Services</option> <option value="168">Trustee</option> <option value="65">Utilities</option> <option value="200">Veteran Owned</option> <option value="64">Veterinarians</option> <option value="169">Waste Disposal</option> <option value="170">Water Solutions</option> <option value="171">Webdesigners</option> <option value="53">Wholesale Distribution</option> <option value="199">Woman Owned</option> </select> <div class="invalid-feedback"> Please select a directory category. </div> </div> <div class="form-group col-6 col-sm-4 gz-step2-bus-full"> <label for="AppFormAddEmpFull">Full-time Employees <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormAddEmpFull" name="NewMemberInfo.MemEmpFullTime" placeholder="0" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your number of full-time employees. </div> </div> <div class="form-group col-6 col-sm-4 gz-step2-bus-full"> <label for="AppFormAddEmpPart">Part-time Employees <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormAddEmpPart" name="NewMemberInfo.MemEmpPartTime" placeholder="0" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your number of part-time employees. </div> </div>   </div>  <div class="form-row gz-memberapp-step gz-primary-group" data-step="3" id="step3">  <div class="col-12 gz-step3-title"> <h3 class="gz-subtitle">Step 3:</h3> </div> <div class="col-12 gz-step3-primlabel"> <h5 class="gz-subtitle">Primary Contact</h5> </div> <div class="col-12 gz-rep-fields gz-primary-rep"> <div class="form-row"> <div class="form-group col-6 gz-step3-primname gz-first-name"> <label for="AppFormPrimName">First Name <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimName" name="NewMemberInfo.PriRepFirstName" placeholder="Joe" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your first name. </div> </div> <div class="form-group col-6 gz-step3-primlast gz-last-name"> <label for="AppFormPrimLast">Last Name <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimLast" name="NewMemberInfo.PriRepLastName" placeholder="Smith" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your last name. </div> </div> <div class="form-group col-6 col-md-3 gz-step3-primtit gz-title"> <label for="AppFormPrimTitle">Title </label> <input class="form-control" id="AppFormPrimTitle" name="NewMemberInfo.PriRepTitle" placeholder="Project Manager" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step3-primph gz-phone"> <label for="AppFormPrimPhone">Phone <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimPhone" name="NewMemberInfo.PriRepPhone" placeholder="(000) 000-0000" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your phone number. </div> </div> <div class="form-group col-6 col-md-3 gz-step3-primcell gz-cell"> <label for="AppFormPrimCell">Cell Phone </label> <input class="form-control" id="AppFormPrimCell" name="NewMemberInfo.PriRepCellPhone" placeholder="(000) 000-0000" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step3-primfax gz-fax"> <label for="AppFormPrimFax">Fax </label> <input class="form-control" id="AppFormPrimFax" name="NewMemberInfo.PriRepFax" placeholder="(000) 000-0000" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step3-primemail gz-email"> <label for="AppFormPrimEmail">Email <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimEmail" name="NewMemberInfo.PriRepEMail" pattern="^[a-zA-Z0-9._-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,62}$" placeholder="info@example.com" required="" type="text" value="" /> <div class="invalid-feedback"> Please add a valid email. </div> </div> </div> </div> <div class="form-group col-12 gz-step3-primpref"> <p class="gz-contact-pref-label">Contact Preference</p> <div class="form-check radio-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppPrefEmail" name="NewMemberInfo.PriRepContactPref" type="radio" value="EMail" /> <label class="form-check-label" for="AppPrefEmail">Email</label> </div> <div class="form-check radio-lg form-check-inline mr-5"> <input class="form-check-input" id="AppPrefPhone" name="NewMemberInfo.PriRepContactPref" type="radio" value="Phone" /> <label class="form-check-label" for="AppPrefPhone">Phone</label> </div> </div> <div class="col-12 gz-step3-addlabel"> <h5 class="gz-subtitle">Address</h5> </div> <div class="col-12 gz-address-fields gz-inherited-fields gz-primary-address gz-is-inherited"> <div class="form-row"> <div class="form-group col-12 gz-same-as-above"> <div class="form-check checkbox-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppFormSameAsM" name="NewMemberInfo.PriRepMailAdrsIsCompanyAdrs" type="checkbox" value="true" /><input name="NewMemberInfo.PriRepMailAdrsIsCompanyAdrs" type="hidden" value="false" /> <label class="form-check-label" for="AppFormSameAsM">Same as Address in Step 1</label> </div> </div> <div class="form-group col-12 col-sm-6 gz-step3-add1 gz-address-1"> <label for="AppFormPrimNameAddress">Address line 1 <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimNameAddress" name="NewMemberInfo.PriRepMailAdrs1" placeholder="123 Example Street" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your address. </div> </div> <div class="form-group col-12 col-sm-6 gz-step3-add2 gz-address-2"> <label for="AppFormPrimAddress2">Address line 2 </label> <input class="form-control" id="AppFormPrimAddress2" name="NewMemberInfo.PriRepMailAdrs2" placeholder="Suite 900" type="text" value="" /> </div> <div class="form-group col-6 col-sm-3 gz-step3-country gz-country"> <label for="AppFormPrimCountry">Country <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormPrimCountry" name="NewMemberInfo.PriRepMailCountry" required=""><option value="">Choose...</option> <option value="AF">Afghanistan</option> <option value="AL">Albania</option> <option value="DZ">Algeria</option> <option value="AR">Argentina</option> <option value="AM">Armenia</option> <option value="AU">Australia</option> <option value="AT">Austria</option> <option value="AZ">Azerbaijan</option> <option value="BS">Bahamas</option> <option value="BH">Bahrain</option> <option value="BD">Bangladesh</option> <option value="BE">Belgium</option> <option value="BZ">Belize</option> <option value="BM">Bermuda</option> <option value="BM">Bermuda</option> <option value="BT">Bhutan</option> <option value="BO">Bolivia</option> <option value="BA">Bosnia and Herzegovina</option> <option value="BW">Botswana</option> <option value="BR">Brazil</option> <option value="VG">British Virgin Islands</option> <option value="BN">Brunei</option> <option value="BG">Bulgaria</option> <option value="KH">Cambodia</option> <option value="CM">Cameroon</option> <option value="CA">Canada</option> <option value="029">Caribbean</option> <option value="CL">Chile</option> <option value="CN">China</option> <option value="CO">Colombia</option> <option value="CD">Congo (DRC)</option> <option value="CR">Costa Rica</option> <option value="CI">Côte d鈥橧voire</option> <option value="HR">Croatia</option> <option value="CU">Cuba</option> <option value="CZ">Czechia</option> <option value="DK">Denmark</option> <option value="DO">Dominican Republic</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="FO">Faroe Islands</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GT">Guatemala</option> <option value="HT">Haiti</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong SAR</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IE">Ireland</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KR">Korea</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Laos</option> <option value="419">Latin America</option> <option value="LV">Latvia</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao SAR</option> <option value="MK">Macedonia, FYRO</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MX">Mexico</option> <option value="MD">Moldova</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="ME">Montenegro</option> <option value="MA">Morocco</option> <option value="MM">Myanmar</option> <option value="NP">Nepal</option> <option value="NL">Netherlands</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NG">Nigeria</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PA">Panama</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="RE">Réunion</option> <option value="RO">Romania</option> <option value="RU">Russia</option> <option value="RW">Rwanda</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="RS">Serbia</option> <option value="SG">Singapore</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SO">Somalia</option> <option value="ZA">South Africa</option> <option value="ES">Spain</option> <option value="LK">Sri Lanka</option> <option value="SE">Sweden</option> <option value="CH">Switzerland</option> <option value="TW">Taiwan</option> <option value="TJ">Tajikistan</option> <option value="TH">Thailand</option> <option value="TT">Trinidad and Tobago</option> <option value="TN">Tunisia</option> <option value="TR">Türkiye</option> <option value="TM">Turkmenistan</option> <option value="UA">Ukraine</option> <option value="AE">United Arab Emirates</option> <option value="GB">United Kingdom</option> <option selected="selected" value="US">United States</option> <option value="UY">Uruguay</option> <option value="UZ">Uzbekistan</option> <option value="VE">Venezuela</option> <option value="VN">Vietnam</option> <option value="001">World</option> <option value="YE">Yemen</option> </select> <div class="invalid-feedback"> Please add your country. </div> </div> <div class="form-group col-6 col-sm-3 gz-step3-city gz-city"> <label for="AppFormPrimCity">City <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimCity" name="NewMemberInfo.PriRepMailCity" placeholder="Orlando" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your City. </div> </div> <div class="form-group col-6 col-sm-3 gz-step3-state gz-state"> <div class="state-drop" style="display: none;"> <label for="AppFormPrimStateDrop">State <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormPrimStateDrop" name="NewMemberInfo.PriRepMailState" required=""><option value="">Choose...</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FM">Federated States of Micronesia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="MP">Northern Mariana Islands</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VI">Virgin Islands</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> <div class="invalid-feedback"> Please add your State. </div> </div> <div class="province-drop" style="display: none;"> <label for="AppFormPrimProvinceDrop">State </label> <select class="form-control" id="AppFormPrimProvinceDrop" name="NewMemberInfo.PriRepMailState"><option value="">Choose...</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NT">Northwest Territories</option> <option value="NS">Nova Scotia</option> <option value="NU">Nunavut</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon</option> </select> </div> <div class="state-field"> <label for="AppFormPrimState">State <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimState" name="NewMemberInfo.PriRepMailState" placeholder="MN" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your State. </div> </div> </div> <div class="form-group col-6 col-sm-3 gz-step3-zip gz-zip"> <label for="AppFormPrimZip">Postal Code <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimZip" name="NewMemberInfo.PriRepMailZip" placeholder="54321" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your Postal Code. </div> </div> </div> </div> <div class="col-12 gz-step3-social"> <h5 class="gz-subtitle">Social Network Addresses</h5> </div> <div class="form-group col-6 col-md-4 gz-step3-socialli"> <label for="PriRepSocialNetworkID_1">LinkedIn </label> <input type="text" class="form-control" name="PriRepSocialNetworkID_1" id="PriRepSocialNetworkID_1" placeholder="https://linkedin.com"> </div> <div class="form-group col-6 col-md-4 gz-step3-socialli"> <label for="PriRepSocialNetworkID_2">Facebook </label> <input type="text" class="form-control" name="PriRepSocialNetworkID_2" id="PriRepSocialNetworkID_2" placeholder="https://facebook.com"> </div> <div class="form-group col-6 col-md-4 gz-step3-socialli"> <label for="PriRepSocialNetworkID_3">Instagram </label> <input type="text" class="form-control" name="PriRepSocialNetworkID_3" id="PriRepSocialNetworkID_3" placeholder="https://instagram.com"> </div> <div class="form-group col-6 col-md-4 gz-step3-socialli"> <label for="PriRepSocialNetworkID_11">X </label> <input type="text" class="form-control" name="PriRepSocialNetworkID_11" id="PriRepSocialNetworkID_11" placeholder="https://x.com"> </div> <div class="form-group col-6 col-md-4 gz-step3-socialli"> <label for="PriRepSocialNetworkID_5">TikTok </label> <input type="text" class="form-control" name="PriRepSocialNetworkID_5" id="PriRepSocialNetworkID_5" placeholder="https://tiktok.com"> </div> <div class="col-12 gz-step3-primlabel"> <h5 class="gz-subtitle">Create Account</h5> </div> <div class="form-group col-12 gz-step3-primca gz-login-creation"> <input style="display:none" class="form-control" data-login="PriRepLogin" data-pwd="PriRepPwd" aria-label="Primary login already in use" > <div class="invalid-feedback">This Login is already in use</div> </div> <div class="form-group col-6 gz-step3-primlogin gz-login"> <label for="AppFormPrimLog">Login <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimLog" name="NewMemberInfo.PriRepLogin" placeholder="smith" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your login username. </div> </div> <div class="form-group col-6 gz-step3-primpass gz-pass"> <label for="AppFormPrimPswrd">Password <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormPrimPswrd" name="NewMemberInfo.PriRepPwd" placeholder="password" required="" type="password" value="" /> <div class="invalid-feedback"> Please add your login password. </div> </div> </div>  <div class="form-row gz-memberapp-step gz-inherited-fields gz-is-inherited" data-step="4" id="step4">  <div class="col-12 gz-step4-title"> <h3 class="gz-subtitle">Step 4:</h3> </div> <div class="col-12 gz-step4-billlabel"> <h5 class="gz-subtitle">Billing Contact</h5> </div> <div class="col-12 gz-rep-fields"> <div class="form-row"> <div class="form-group col-12 gz-same-as-above"> <div class="form-check checkbox-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppFormSameAsPC" name="NewMemberInfo.PriRepIsBillRep" type="checkbox" value="true" /><input name="NewMemberInfo.PriRepIsBillRep" type="hidden" value="false" /> <label class="form-check-label" for="AppFormSameAsPC">Same as Primary Contact</label> </div> </div> <div class="form-group col-6 gz-step4-name gz-first-name"> <label for="AppFormBillName">First Name <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillName" name="NewMemberInfo.BillRepFirstName" placeholder="Joe" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your first name. </div> </div> <div class="form-group col-6 gz-step4-last gz-last-name"> <label for="AppFormBillLast">Last Name <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillLast" name="NewMemberInfo.BillRepLastName" placeholder="Smith" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your last name. </div> </div> <div class="form-group col-6 col-md-3 gz-step4-title gz-title"> <label for="AppFormBillTitle">Title </label> <input class="form-control" id="AppFormBillTitle" name="NewMemberInfo.BillRepTitle" placeholder="Project Manager" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step4-phone gz-phone"> <label for="AppFormBillPhone">Phone <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillPhone" name="NewMemberInfo.BillRepPhone" placeholder="(000) 000-0000" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your phone number. </div> </div> <div class="form-group col-6 col-md-3 gz-step4-cell gz-cell"> <label for="AppFormBillCell">Cell Phone </label> <input class="form-control" id="AppFormBillCell" name="NewMemberInfo.BillRepCellPhone" placeholder="(000) 000-0000" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step4-fax gz-fax"> <label for="AppFormBillFax">Fax </label> <input class="form-control" id="AppFormBillFax" name="NewMemberInfo.BillRepFax" placeholder="(000) 000-0000" type="text" value="" /> </div> <div class="form-group col-6 col-md-3 gz-step4-email gz-email"> <label for="AppFormBillEmail">Email <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillEmail" name="NewMemberInfo.BillRepEMail" pattern="^[a-zA-Z0-9._-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,62}$" placeholder="info@example.com" required="" type="text" value="" /> <div class="invalid-feedback"> Please add a valid email. </div> </div> </div> </div> <div class="form-group col-12 gz-step4-pref"> <p class="gz-contact-pref-label">Contact Preference</p> <div class="form-check radio-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppBillPrefEmail" name="NewMemberInfo.BillRepContactPref" type="radio" value="EMail" /> <label class="form-check-label" for="AppBillPrefEmail">Email</label> </div> <div class="form-check radio-lg form-check-inline mr-5"> <input class="form-check-input" id="AppBillPrefphone" name="NewMemberInfo.BillRepContactPref" type="radio" value="Phone" /> <label class="form-check-label" for="AppBillPrefphone">Phone</label> </div> </div> <div class="form-group col-12 gz-step4-addlabel"> <h5 class="gz-subtitle">Address</h5> </div> <div class="col-12 gz-address-fields gz-inherited-fields gz-billing-address gz-is-inherited"> <div class="form-row"> <div class="col-12 gz-step4-sameas gz-same-as-above" style="display:none"> <div class="form-check checkbox-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppBillSameAsMA" name="NewMemberInfo.BillRepMailAdrsIsPrimaryAdrs" type="checkbox" value="true" /><input name="NewMemberInfo.BillRepMailAdrsIsPrimaryAdrs" type="hidden" value="false" /> <label class="form-check-label" for="AppBillSameAsMA">Same as Primary Contact Address</label> </div> </div> <div class="form-group col-12 col-sm-6 gz-step4-add1 gz-address-1"> <label for="AppFormBillAdd">Address line 1 <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillAdd" name="NewMemberInfo.BillRepMailAdrs1" placeholder="123 Example Street" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your address. </div> </div> <div class="form-group col-12 col-sm-6 gz-step4-add2 gz-address-2"> <label for="AppFormBillAdd2">Address line 2 </label> <input class="form-control" id="AppFormBillAdd2" name="NewMemberInfo.BillRepMailAdrs2" placeholder="Suite 900" type="text" value="" /> </div> <div class="form-group col-6 col-sm-3 gz-step4-country gz-country"> <label for="AppFormBillCountry">Country <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormBillCountry" name="NewMemberInfo.BillRepMailCountry" required=""><option value="">Choose...</option> <option value="AF">Afghanistan</option> <option value="AL">Albania</option> <option value="DZ">Algeria</option> <option value="AR">Argentina</option> <option value="AM">Armenia</option> <option value="AU">Australia</option> <option value="AT">Austria</option> <option value="AZ">Azerbaijan</option> <option value="BS">Bahamas</option> <option value="BH">Bahrain</option> <option value="BD">Bangladesh</option> <option value="BE">Belgium</option> <option value="BZ">Belize</option> <option value="BM">Bermuda</option> <option value="BM">Bermuda</option> <option value="BT">Bhutan</option> <option value="BO">Bolivia</option> <option value="BA">Bosnia and Herzegovina</option> <option value="BW">Botswana</option> <option value="BR">Brazil</option> <option value="VG">British Virgin Islands</option> <option value="BN">Brunei</option> <option value="BG">Bulgaria</option> <option value="KH">Cambodia</option> <option value="CM">Cameroon</option> <option value="CA">Canada</option> <option value="029">Caribbean</option> <option value="CL">Chile</option> <option value="CN">China</option> <option value="CO">Colombia</option> <option value="CD">Congo (DRC)</option> <option value="CR">Costa Rica</option> <option value="CI">Côte d鈥橧voire</option> <option value="HR">Croatia</option> <option value="CU">Cuba</option> <option value="CZ">Czechia</option> <option value="DK">Denmark</option> <option value="DO">Dominican Republic</option> <option value="EC">Ecuador</option> <option value="EG">Egypt</option> <option value="SV">El Salvador</option> <option value="ER">Eritrea</option> <option value="EE">Estonia</option> <option value="ET">Ethiopia</option> <option value="FO">Faroe Islands</option> <option value="FI">Finland</option> <option value="FR">France</option> <option value="GE">Georgia</option> <option value="DE">Germany</option> <option value="GH">Ghana</option> <option value="GR">Greece</option> <option value="GL">Greenland</option> <option value="GT">Guatemala</option> <option value="HT">Haiti</option> <option value="HN">Honduras</option> <option value="HK">Hong Kong SAR</option> <option value="HU">Hungary</option> <option value="IS">Iceland</option> <option value="IN">India</option> <option value="ID">Indonesia</option> <option value="IE">Ireland</option> <option value="IL">Israel</option> <option value="IT">Italy</option> <option value="JM">Jamaica</option> <option value="JP">Japan</option> <option value="JO">Jordan</option> <option value="KZ">Kazakhstan</option> <option value="KE">Kenya</option> <option value="KR">Korea</option> <option value="KW">Kuwait</option> <option value="KG">Kyrgyzstan</option> <option value="LA">Laos</option> <option value="419">Latin America</option> <option value="LV">Latvia</option> <option value="LI">Liechtenstein</option> <option value="LT">Lithuania</option> <option value="LU">Luxembourg</option> <option value="MO">Macao SAR</option> <option value="MK">Macedonia, FYRO</option> <option value="MY">Malaysia</option> <option value="MV">Maldives</option> <option value="ML">Mali</option> <option value="MT">Malta</option> <option value="MX">Mexico</option> <option value="MD">Moldova</option> <option value="MC">Monaco</option> <option value="MN">Mongolia</option> <option value="ME">Montenegro</option> <option value="MA">Morocco</option> <option value="MM">Myanmar</option> <option value="NP">Nepal</option> <option value="NL">Netherlands</option> <option value="NZ">New Zealand</option> <option value="NI">Nicaragua</option> <option value="NG">Nigeria</option> <option value="NO">Norway</option> <option value="OM">Oman</option> <option value="PK">Pakistan</option> <option value="PA">Panama</option> <option value="PY">Paraguay</option> <option value="PE">Peru</option> <option value="PH">Philippines</option> <option value="PL">Poland</option> <option value="PT">Portugal</option> <option value="PR">Puerto Rico</option> <option value="RE">Réunion</option> <option value="RO">Romania</option> <option value="RU">Russia</option> <option value="RW">Rwanda</option> <option value="SA">Saudi Arabia</option> <option value="SN">Senegal</option> <option value="RS">Serbia</option> <option value="SG">Singapore</option> <option value="SK">Slovakia</option> <option value="SI">Slovenia</option> <option value="SO">Somalia</option> <option value="ZA">South Africa</option> <option value="ES">Spain</option> <option value="LK">Sri Lanka</option> <option value="SE">Sweden</option> <option value="CH">Switzerland</option> <option value="TW">Taiwan</option> <option value="TJ">Tajikistan</option> <option value="TH">Thailand</option> <option value="TT">Trinidad and Tobago</option> <option value="TN">Tunisia</option> <option value="TR">Türkiye</option> <option value="TM">Turkmenistan</option> <option value="UA">Ukraine</option> <option value="AE">United Arab Emirates</option> <option value="GB">United Kingdom</option> <option selected="selected" value="US">United States</option> <option value="UY">Uruguay</option> <option value="UZ">Uzbekistan</option> <option value="VE">Venezuela</option> <option value="VN">Vietnam</option> <option value="001">World</option> <option value="YE">Yemen</option> </select> <div class="invalid-feedback"> Please add your country. </div> </div> <div class="form-group col-6 col-sm-3 gz-step4-city gz-city"> <label for="AppFormBillCity">City <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillCity" name="NewMemberInfo.BillRepMailCity" placeholder="Orlando" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your City. </div> </div> <div class="form-group col-6 col-sm-3 gz-step4-state gz-state"> <div class="state-drop" style="display: none;"> <label for="AppFormBillStateDrop">State <span class="gz-form-req" title="Required field">*</span> </label> <select class="form-control" id="AppFormBillStateDrop" name="NewMemberInfo.BillRepMailState" required=""><option value="">Choose...</option> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AS">American Samoa</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FM">Federated States of Micronesia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MH">Marshall Islands</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="MP">Northern Mariana Islands</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PW">Palau</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VI">Virgin Islands</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> <div class="invalid-feedback"> Please add your State. </div> </div> <div class="province-drop" style="display: none;"> <label for="AppFormBillProvinceDrop">State </label> <select class="form-control" id="AppFormBillProvinceDrop" name="NewMemberInfo.BillRepMailState"><option value="">Choose...</option> <option value="AB">Alberta</option> <option value="BC">British Columbia</option> <option value="MB">Manitoba</option> <option value="NB">New Brunswick</option> <option value="NL">Newfoundland and Labrador</option> <option value="NT">Northwest Territories</option> <option value="NS">Nova Scotia</option> <option value="NU">Nunavut</option> <option value="ON">Ontario</option> <option value="PE">Prince Edward Island</option> <option value="QC">Quebec</option> <option value="SK">Saskatchewan</option> <option value="YT">Yukon</option> </select> </div> <div class="state-field"> <label for="AppFormBillState">State <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillState" name="NewMemberInfo.BillRepMailState" placeholder="MN" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your State. </div> </div> </div> <div class="form-group col-6 col-sm-3 gz-step4-zip gz-zip"> <label for="AppFormBillZip">Postal Code <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillZip" name="NewMemberInfo.BillRepMailZip" placeholder="54321" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your Postal Code. </div> </div> </div> </div> <div class="form-group col-12 gz-step4-socallabel"> <h5 class="gz-subtitle">Social Network Addresses</h5> </div> <div class="form-group col-6 col-md-4 gz-step4-socialli gz-social"> <label for="BillRepSocialNetworkID_1">LinkedIn </label> <input type="text" class="form-control" name="BillRepSocialNetworkID_1" id="BillRepSocialNetworkID_1" placeholder="https://linkedin.com" > </div> <div class="form-group col-6 col-md-4 gz-step4-socialli gz-social"> <label for="BillRepSocialNetworkID_2">Facebook </label> <input type="text" class="form-control" name="BillRepSocialNetworkID_2" id="BillRepSocialNetworkID_2" placeholder="https://facebook.com" > </div> <div class="form-group col-6 col-md-4 gz-step4-socialli gz-social"> <label for="BillRepSocialNetworkID_3">Instagram </label> <input type="text" class="form-control" name="BillRepSocialNetworkID_3" id="BillRepSocialNetworkID_3" placeholder="https://instagram.com" > </div> <div class="form-group col-6 col-md-4 gz-step4-socialli gz-social"> <label for="BillRepSocialNetworkID_11">X </label> <input type="text" class="form-control" name="BillRepSocialNetworkID_11" id="BillRepSocialNetworkID_11" placeholder="https://x.com" > </div> <div class="form-group col-6 col-md-4 gz-step4-socialli gz-social"> <label for="BillRepSocialNetworkID_5">TikTok </label> <input type="text" class="form-control" name="BillRepSocialNetworkID_5" id="BillRepSocialNetworkID_5" placeholder="https://tiktok.com" > </div>  <div class="form-group col-12 gz-step3-primlabel"> <h5 class="gz-subtitle">Create Account</h5> </div> <div class="form-group col-12 gz-step4-ca gz-login-creation"> <input style="display:none" class="form-control" data-login="BillRepLogin" data-pwd="BillRepPwd" aria-label="Billing login already in use" > <div class="invalid-feedback">This Login is already in use</div> </div> <div class="form-group col-6 gz-step4-login gz-login"> <label for="AppBillLog">Login <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppBillLog" name="NewMemberInfo.BillRepLogin" placeholder="smith" required="" type="text" value="" /> <div class="invalid-feedback"> Please add your login username. </div> </div> <div class="form-group col-6 gz-step4-pass gz-pass"> <label for="AppFormBillPswrd">Password <span class="gz-form-req" title="Required field">*</span> </label> <input class="form-control" id="AppFormBillPswrd" name="NewMemberInfo.BillRepPwd" placeholder="password" required="" type="password" value="" /> <div class="invalid-feedback"> Please add your login password. </div> </div> </div>  <div class="form-row gz-memberapp-step" data-step="5" id="step5"> <div class="col-12 gz-step5-title"> <h3 class="gz-subtitle">Step 5:</h3> </div> <div class="col-12 gz-step5-pckglabel"> <h5 class="gz-subtitle">Membership Package</h5> </div> <div class="col-12 form-group gz-step5-packages"> <input style="display:none" class="form-control" data-application-package="true" required aria-label="Select membership package"> <div class="invalid-feedback"> Please select a Membership Package </div> <input type="hidden" id="SwitchedToMonthly" name="NewMemberInfo.SwitchedToMonthly" value="0" />  <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg24" value="24" >  <label class="form-check-label" for="AppFormPkg24"> <span class="gz-memberapp-pkgname"> <strong>Platinum Membership</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="541.67" data-annual-amount="6,500">6,500</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">Platinum members are premier partners of the Chamber of Commerce and receive benefits exclusive to this level plus all of the services and benefits of the traditional level.</span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg23" value="23" >  <label class="form-check-label" for="AppFormPkg23"> <span class="gz-memberapp-pkgname"> <strong>Gold Membership</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="291.67" data-annual-amount="3,500">3,500</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">Gold members kick it up a notch and get to transform their business with in-person participation at most Chamber events held annually, plus all of the services and benefits of the traditional level. This level is open to all business.</span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg22" value="22" >  <label class="form-check-label" for="AppFormPkg22"> <span class="gz-memberapp-pkgname"> <strong>Silver Membership</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="166.67" data-annual-amount="2,000">2,000</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">Silver members receive even more visibility and services built into membership plus all of the services and benefits of the traditional level. It is not available to business with 81 or more full time equivalent employees.</span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg21" value="21" >  <label class="form-check-label" for="AppFormPkg21"> <span class="gz-memberapp-pkgname"> <strong>Bronze Membership</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="79.17" data-annual-amount="950">950</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">Bronze members get all of the marketing, advertising, and recognition needed to shine the light on their business plus all of the services and benefits of the traditional level. It is not available to business with 41 or more full time equivalent employees.</span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg20" value="20" >  <label class="form-check-label" for="AppFormPkg20"> <span class="gz-memberapp-pkgname"> <strong>Traditional Membership </strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="29.17" data-annual-amount="350">350</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">The traditional membership includes the basics of a chamber membership. It is not available to business with 11 or more full time equivalent employees.</span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg14" value="14" >  <label class="form-check-label" for="AppFormPkg14"> <span class="gz-memberapp-pkgname"> <strong>Citizen Member- Couple</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="18.75" data-annual-amount="225">225</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">The traditional membership for the citizen couple includes the basics of a chamber membership. </span>    </div> </label> </div> <div class="form-check radio-lg gz-membership-package col-12"> <input data-is-monthly="0" class="form-check-input gz-membership-package-select" type="radio" name="NewMemberInfo.MemberAppPkg" id="AppFormPkg13" value="13" >  <label class="form-check-label" for="AppFormPkg13"> <span class="gz-memberapp-pkgname"> <strong>Citizen Member: Individual</strong> </span> <span class="fee-item-wrapper"> <span class="badge badge-pill badge-dark gz-memberapp-pkgfee"> $ <span class="fee-item-amount" data-monthly-amount="12.50" data-annual-amount="150">150</span> <span class="fee-item-freq">annually</span> </span> <span class="gz-memberapp-pkgfeeinput"><a class="switch-frequency" href="#">Switch to monthly autopay?</a></span> </span> <div> <span class="gz-memberapp-pkgdesc">The traditional membership for the individual citizen includes the basics of a chamber membership.</span>    </div> </label> </div> </div>  <div class="col-12 gz-step5-opplabel"> <h5 class="gz-subtitle">Additional Fees:</h5> </div> <div class="col-12 form-group gz-step5-opps"> <div class="form-check checkbox-lg col-12"> <input type="checkbox" name="NewMemberInfo.AddOns" class="form-check-input" id="AppFormOpp1" disabled readonly checked value="1" /> <label class="form-check-label" for="AppFormOpp1"> <span class="gz-memberapp-addonname"> <strong>Application Fee</strong> </span> <span class="badge badge-pill badge-dark gz-memberapp-addonfee"> <span class="gz-memberapp-addonfeename">$35 one time</span> </span> <div class="gz-memberapp-addondesc">Application processing fee.</div> </label> </div> <input type="hidden" name="NewMemberInfo.AddOns" value="1" /> </div> <div class="form-group col-12 gz-step2-bus-comm"> <label for="AppFormBusComm">Comments/Questions </label> <textarea class="form-control" cols="20" id="AppFormBusComm" name="NewMemberInfo.MemberCommentQuest" placeholder="Add your comments here." rows="2"> </textarea> </div> <div class="col-12 gz-step5-pylabel"> <h5 class="gz-subtitle">Payment Option</h5> </div> <div class="col-12 form-group gz-step5-pyoptions"> <div class="form-check radio-lg form-check-inline mr-5"> <input checked="checked" class="form-check-input" id="AppFormPymnt2" name="NewMemberInfo.MbrPmtOpt" type="radio" value="CC" /> <label class="form-check-label" for="AppFormPymnt2">Charge my credit or debit card</label> </div> </div> <div class="col-12 gz-comm-captcha"> <input style="display:none" class="form-control" data-recaptcha="true" required aria-hidden="true" aria-label="Captcha validation" > <div class="invalid-feedback"> Please complete the Captcha </div> <div class="g-recaptcha" data-sitekey="6LcpNUMUAAAAAB5iVpO_rzGG2TK_vFp7V6SCw_4s" data-callback="verifyRecaptchaCallback" data-expired-callback="expiredRecaptchaCallback"></div> </div> </div>  <div class="form-row"> <div class="col-12 gz-back-next" role="group" aria-label="Back submit or print buttons"> <a type="button" class="btn gz-back-btn gz-app-transition" href="#">Back</a> <a type="button" class="btn gz-next-btn gz-app-transition" href="#">Next</a> <a class="btn submit-btn" type="button" href="javascript:null">Submit Application</a> <a class="btn print-btn" type="button" onclick="return!MNI.Window.Print(this)" rel="nofollow" href="https://business.portageinchamber.com/member/newmemberapp?rendermode=print" >Print Application</a> </div> </div> </form> </div> </div> <div class="row gz-footer-navigation" role="navigation"> <div class="col"> <a href="https://business.portageinchamber.com/list/">Business Directory</a> <a href="https://business.portageinchamber.com/news/">News Releases</a> <a href="https://business.portageinchamber.com/events/">Events Calendar</a> <a href="https://business.portageinchamber.com/hotdeals/">Hot Deals</a> <a href="https://business.portageinchamber.com/MemberToMember/">Member To Member Deals</a> <a href="https://business.portageinchamber.com/jobs/">Job Postings</a> <a href="https://business.portageinchamber.com/contact/">Contact Us</a> <a href="https://business.portageinchamber.com/info/">Information & Brochures</a> <a href="https://business.portageinchamber.com/member/NewMemberApp/">Join The Chamber</a> </div> </div> <div class="row gz-footer-logo"> <div class="col text-center"> <a href="http://www.growthzone.com/" target="_blank"> <img alt="GrowthZone - Membership Management Software" src="https://public.chambermaster.com/content/images/powbyCM_100x33.png" border="0"> </a> </div> </div> </div>    <script type="text/javascript"> (function ($) { $(function () { var $gzns = $('#gzns'); var $info = $('#gzns').find('.col-sm-6.col-md-4'); if ($gzns.width() > 950) { $info.addClass('col-lg-3'); } var store = window.localStorage; var key = "14-list-view"; var printKey = "24-list-view"; $('.gz-view-btn').click(function (e) { e.preventDefault(); $('.gz-view-btn').removeClass('active'); $(this).addClass('active'); if ($(this).hasClass('gz-list-view')) { store.setItem(key, true); store.setItem(printKey, true); 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MNI.Path.MemberKeywordSearch(item.Name) : MNI.Path.Member(item.SlugWithID); doAction(location); } break; } }) $('#category-select').change(function () { // Store the category ID in a hidden field so the remote fetch can use it when necessary var categoryId = $('#category-select option:selected').val(); $('#catgId').val(categoryId); // Don't rely on prior locally cached data when the category is changed. $('.member-typeahead').typeahead('destroy'); $('.member-typeahead').typeahead({ hint: false, }, { display: 'Name', source: members, limit: Infinity, templates: { suggestion: function (data) { return '<div class="mn-autocomplete"><span class="mn-autocomplete-name">' + data.Name + '</span></br><span class="mn-autocomplete-type">' + data.Type + '</span></div>' } } }); }); MNI.Plugins.AutoComplete.Init('#mn-search-geoip input', { path: '/' + MNI.MemberFilterUrl + '/find-geographic' }); }); })(MNI.jQuery); </script> </div> </p> </div> </div> </div> </div> </div> </div> </div> </div> </div> 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