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.

Configure for price

Membership Level ^* Community Representative (+$125.00) Select membership tier. For an explanation of each tier level, please click on thumbnail to enlarge it. For community representatives or non-profits, please use the Community Rep/Non-Profit regsitration form.

Set up fee ^* Set up fee (+$25.00) , 25.00kg

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.

Fax

Business fax number

Web Address

Your business website (if it exists).

Referred By

Name of the person who referred you to the Chamber

Names of Additional Representatives

Names of any additional company representatives and their email addresses.

Billing Address

Enter this if different from mailing address.

How many ?

Community Rep/Non-Profit (new)

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