Community Rep/Non-Profit (new)

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Community representatives and non-profit organizations applying for the first time should use this form. New membership application prices include a one-time $25 setup fee.

If renewing your membership, please use this form.

$150.00

Firm Name ^*The name of the business applying for membership

Type of Business ^*The type of business applying for membership

Main Representative ^*The name of the main representative of the business.

Position Title ^*Main representative's position and/or title.

Mailing Address ^*The mailing address of the business.

Email Address ^*The mailing address used to receive correspondence from the Chamber.

Phone ^*Business phone number.

FaxBusiness fax number

Web AddressYour business website (if it exists).

Referred ByName of the person who referred you to the Chamber

Names of Additional RepresentativesNames of any additional company representatives and their email addresses.

Billing AddressEnter this if different from mailing address.

How many ?

Community Rep/Non-Profit (new)

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