Membership Application

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Join the Chamber and grow your business. Check out the Top 10 Reasons to Join.

Get a hands on experience about all of the ways the Chamber could be your #1 Resource at an upcoming Membership Orientation.

Still have questions? Contact Brittany Carter, Director of Membership to talk out the benefits with.

Organization Information (to be displayed online)

Organization Name *

Address 1 *

Address 2

City *

State *

Zip *

Phone *

Fax

Website

Email *

Main Contact

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Title

Phone *

Email *

Additional Contacts

Billing Address (if different)

Street

City

State

Zip

Mailing Address (if different)

Street

City

State

Zip

Additional Information

Referred by

How did you hear about us?

What is your reason for joining?

Please have someone contact me regarding

*Check all that apply
Business Resources
Community Involvement
Cost Savings Programs (Insurance, Office Supplies, Worker's Compensation)
Economic Development
Government Relations
Networking

Other

Membership Investment

Membership Type: *

This membership type is reserved for owner-operated entities or companies with fewer than 4 employees.

Primary Directory Category *

Additional Directory Categories

Primary Directory listing is complimentary
additional Directory listings are $75 each

**Hold CTRL on your keyboard to select multiple categories**

Number of Employees:

Annual Membership Investment

Additional Categories Cost

$

Enhanced Membership (+ 24% membership investment)

One-Time Application Fee

$

Tax

$

Total: $

Number of Part Time Employees:
Number of Rooms (Accommodations):
Number of Seats (Restaurants):
Number of Associates (Realtors, Attorneys):
Number of Locations ($35/add. location):
Millions in Assets (Financial Institutions):
The contents of this box are for testing purposes. This box will be removed when the form goes live. Full-Time Employees Required Please enter a valid number Please enter a valid date Part-Time Employees Required Please enter a valid number Please enter a valid date Hotel/Motel Rooms Required Please enter a valid number Please enter a valid date Restaurant Seats Required Please enter a valid number Please enter a valid date Additional Associates Required Please enter a valid number Please enter a valid date Additional Associates Cost Required Please enter a valid number Please enter a valid date Additional Locations Required Please enter a valid number Please enter a valid date Additional Locations Cost Required Please enter a valid number Please enter a valid date Assets Required Please enter a valid number Please enter a valid date Assets Cost Required Please enter a valid number Please enter a valid date AdditionalCategories Required Please enter a valid number Please enter a valid date Additional Categories Cost Required Please enter a valid number Please enter a valid date NumberOfAdditionalCategories Required Please enter a valid number Please enter a valid date additionalItem1Cost Required Please enter a valid number Please enter a valid date Annual Dues (charged to card) Required Please enter a valid number Please enter a valid date Tax (charged to card) Required Please enter a valid number Please enter a valid date Fee (charged to card) Required Please enter a valid number Please enter a valid date tempValueForDropDown1 Required Please enter a valid number Please enter a valid date
Payment Type *
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

Discover

Amex

Credit Card Number *

Name On Card	Required
Security Code	Required
Valid Through
	Use Address Above
Credit Card Address 1	Required
Credit Card City	Required
Credit Card State
Credit Card Zip	Required
Credit Card Phone Number	Required
Credit Card Email Address

Please click submit only one time. The transaction may take several seconds.

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