Non Harbor Country Chamber Member Harbor Country Hires Employer Coalition Join Request Please fill required information to become an employer member of the coalition. Business Name * Address Block - US Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Phone Number * Name Block - Simple Main business contact for Harbor Country Hires Employer Coalition decisions and inner communications. Automatically has permissions to post jobs and make financial transactions. First Name * Last Name * Main Contact Email * Job Applicant Business Contact Name You can leave this name field blank if you prefer. First Name Last Name Job Applicant Email Address * Job applicant will use this email address to communicate their interest. Job Applicant Contact Has Permission To Post Jobs YES NO