Please enter all information as you would like it to appear in the SYCBA Member Directory.

	Business Name*
	Contact First Name*
	Contact Last Name*
	Membership Amount	Annual Charges: $80 ($60 for non-profit organization)
	Title
	Address Line 1*
	Address Line 2
	City*
	State*	MD PA
	Zip*
	Phone
	Phone Extension
	Fax
	Email*
	Web Site Address
	Home Phone
	Short Description
	Non-profit?	Check if this is a non-profit organization
	Business Category	Advertising/Media Automotive Banking Business Solutions Communications Financial Services Food Sales/Restaurants Health Care Home Wares Home Services Hospitality Insurance Local/Municipality Manufacturing Non-Profits Retail Community Services Sales Consultants Sports/Recreation Legal Services Real Estate Brown's Orchards & Farm Market
		Please note that a PayPal account is not required for payment. You may click "Pay with debit or credit card" on the next screen if you prefer.