ABOUT US
President's Message
Our Mission
History
Board of Directors
Staff
Directions
Careers
BIA Blog
Contact Us
membership
Member Login
Join BIA
Business Directory
Testimonials
New Member Check List
Member Prospect Referral
Capitol Connect
College for America
BIA Energy Program
NH Rx Card
E-learning Accelerator
Advertising Opportunities
PUBLIC POLICY
Issues
>
Economic Development
Tax Policy
Energy and Telecommunications
EnergizeNH
Environmental Affairs
Human Resources
Health Care
Education
IT and Privacy
Priorities
Policy Development Process
Policy Committees
>
Economic Development and Fiscal Policy
HR/Health Care/Workforce Development
Manufacturing & End Users
roundtables
Strategic Economic Plan for NH
NH Business PAC
Workforce
NEWS ROOM
News Releases
Enterprise
NH Blue Book
Publications
Advertising Opportunities
EVENTS
webinars
Events Calendar
Energy Symposium
Environmental Conferences
Sponsorship Opportunities
covid19
ABOUT US
President's Message
Our Mission
History
Board of Directors
Staff
Directions
Careers
BIA Blog
Contact Us
membership
Member Login
Join BIA
Business Directory
Testimonials
New Member Check List
Member Prospect Referral
Capitol Connect
College for America
BIA Energy Program
NH Rx Card
E-learning Accelerator
Advertising Opportunities
PUBLIC POLICY
Issues
>
Economic Development
Tax Policy
Energy and Telecommunications
EnergizeNH
Environmental Affairs
Human Resources
Health Care
Education
IT and Privacy
Priorities
Policy Development Process
Policy Committees
>
Economic Development and Fiscal Policy
HR/Health Care/Workforce Development
Manufacturing & End Users
roundtables
Strategic Economic Plan for NH
NH Business PAC
Workforce
NEWS ROOM
News Releases
Enterprise
NH Blue Book
Publications
Advertising Opportunities
EVENTS
webinars
Events Calendar
Energy Symposium
Environmental Conferences
Sponsorship Opportunities
covid19
Application
To view this form, please enable JavaScript in your browser.
Company Information
Organization Name
Address 1
Address 2
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
Phone
Fax
Website
Email
Application Authorized By
First Name
Last Name
Title
Phone
Email
Official to Receive Invoice
First Name
Last Name
Title
Phone
Email
Additional Contacts
Contact 1
First Name
Last Name
Title
Email Address
Contact 2
First Name
Last Name
Title
Email Address
Contact 3
First Name
Last Name
Title
Email Address
Contact 4
First Name
Last Name
Title
Email Address
Contact 5
First Name
Last Name
Title
Email Address
Contact 6
First Name
Last Name
Title
Email Address
Contact 7
First Name
Last Name
Title
Email Address
Contact 8
First Name
Last Name
Title
Email Address
Contact 9
First Name
Last Name
Title
Email Address
Contact 10
First Name
Last Name
Title
Email Address
Additional Information
Primary Business Category
None
Associations / Nonprofits
Biotechnology
Chambers of Commerce
Construction
Consulting
Education
Energy Supplier
Engineering Firms
Entertainment
Financial Services
Furniture Dealer
Government
Healthcare
Hospitality
Human Services
Insurance
Law Firms
Life Sciences
Manufacturers
Marketing / Communications Firms
Military
Other
Pest Services
Professional Firms
Public Utilities
Publishing / Media
Real Estate
Retail / Wholesale
Software
Sports
Technology
Telecommunications
Transportation
Travel/Tourism
Utility
Number of Full Time Employees
How did you hear about us?
Membership Investment
Are you a:
Select one...
NH business with NH employees?
a local chamber of commerce?
an out-of-state business?
Annualized New Hampshire Payroll:
Total
The contents of this box are for testing purposes. This box will be removed when the form goes live.
Annual Dues (charged to card)
Annual Membership Investment
Temp Val Drop Down 1
Enhanced Membership ($50)
Additional Directory Categories
Select additional directory categories below by holding the "CTRL" key
Secondary categories may be subject to additional fees
none
Additional Items
Additional Categories Cost
One-Time Application Fee
Number of Part Time Employees
Number of Rooms
Number of Seats
Number of Associates
Number of Locations
Tax
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
Additional Categories
Number Of Additional Categories
Additional Categories Cost
Additional Item 1 Cost
Additional Item 2 Cost
Additional Item 3 Cost
Additional Item 4 Cost
Additional Item 5 Cost
Additional Item 6 Cost
Additional Item 7 Cost
Additional Item 8 Cost
Additional Item 9 Cost
Additional Item 10 Cost
Revenue Item
Tax (charged to card)
Fee (charged to card)
MembershipType
Additional Item 2
Additional Item 3
Additional Item 4
Additional Item 5
Additional Item 6
Additional Item 7
Additional Item 8
Additional Item 9
Additional Item 10
Payment Type
Credit Card
Check
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information
Credit Card Type
Mastercard
Visa
Amex
Credit Card Number
Name on Card
Security Code
Valid Through
01
02
03
04
05
06
07
08
09
10
11
12
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Address
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
Phone
Credit Card Email Address
Please click submit only one time. The transaction may take several seconds.
Quick Links