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Member Application
Thank you for your interest in (VICA) the Valley Industry & Commerce Association!
Business Information
Company Name:
*
Leave Blank:
Phone:
*
Website:
*
Email:
Business Description (200 char max):
Directory Category:
*
--- Select Primary Category ---
Airports
Associations & Chambers
Aviation
Aviation
Banks
Billboards
Business
Business
Communication & Marketing
Consultants
CPA
Education
Employment Services
Energy
Engineering/ Construction
Entertainment
Environmental
Financial
Financial Management
Financial Services
Government
Healthcare
Hospitals
Infrastructure
Insurance
Insurance Providers
Jet Maintance
Jet Maintance
Legal Services
Local
Manufacturers
Not-4-Profits
Offices & District
Private Jet Services
Production (Film,TV)
Property Management
Public Affairs
Publishing
Rail
Real Estate
Real Estate & Development
Restaurant
Retail
Retirement Community
Schools
Sports
Technology
Telecommunications
Tourism & Hospitality
Transportation
Utilities
Wholesale
Youth & Development
Year Founded:
*
Twitter ID:
Facebook ID:
Physical Address
Line 1:
*
Line 2:
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Social Networking:
LinkedIn
Facebook
Twitter
Primary Contact Information
First Name:
*
Last Name:
*
Title:
*
Phone:
*
Cell Phone:
*
Fax:
Email:
*
Contact Preference:
Email
Phone
Login:
*
Password:
*
Address
Same as Member Address
Line 1:
*
Line 2
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Türkiye
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Membership Options
Membership Package:
*
Circle of Influence Membership
:
$1,400.00
-Get Your Feet Wet- Includes tickets to 4 major events, After Darks and Newsmaker Connections.
Business Leaders Membership
:
$1,950.00
-Have a Seat at the Table- Includes a ticket to every event that VICA holds in your membership year.
Bronze Circle of Influence
:
$3,000.00
Customizable Package - Please contact the VICA Office in order to customize your package.
Silver Circle of Influence
:
$6,000.00
Customizable Package - Please contact the VICA Office in order to customize your package.
Gold Circle of Influence
:
$9,000.00
Customizable Package - Please contact the VICA Office in order to customize your package.
Platinum Circle of Influence
:
$12,000.00
Customizable Package - Please contact the VICA Office in order to customize your package.
Premier Partner
:
$17,000.00
Customizable Package - Please contact the VICA Office in order to customize your package.
President's Circle
:
$27,000.00
Customizable Package - Please contact the VICA Office in order to customize your package. The President's Circle is for any membership $27,000 - $39,000.
Small Business Introductory Membership
:
$850.00
Base Membership for One Representative
Payment Option:
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