Gerald Area Chamber of Commerce Membership Form

Submitted by admin on September 21, 2012 - 11:56pm

Type of Membership *

Non Business, Individual $25.00

Non Business, Churches, Civic Groups, Organizations $40.00

Business, 1-10 Employees $50.00

Business, 11-100 Employees $100.00

Business, Over 100 Employees $150.00

Business, Financial Institutions & Utilities $150.00

Select the type of membership for your company

Business or Individual Name *

Name of the business you wish to join the Chamber

Type of Business *

Enter the type of business you do.

Number of Employees *

Enter the total number of employees for this business including the owner.

Representative Name *

Enter the name of the business representative to the chamber.

Title *

Enter the title of the representative named above.

Second Representative (if applicable)

Name a second representative to your membership.

Address *

Enter your mailing address.

City *

Enter your city.

State *

Enter your state.

Zip Code *

Enter your zip code

Office Phone * No dashes

Enter a contact phone number.

Fax Number * No dashes

Enter the business fax number

Cell Number * No dashes

Enter the business fax number.

Email Address *

Enter your business email address.

Web Address *

Enter your businesses web address.

Year Business Established *

Enter the year the business was established.

Year You Acquired the Business *

Year that you purchased the business.

Please compose your description below (25 words max.) *

Enter brief description of your business. Please limit this to 25 words.

Meeting time *

Noon

Evening

Choose the best time for you to attend meetings.

Commitee Interested In *

Choose the committees your interested in participating in.

Gerald Chamber of Commerce

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Gerald Area Chamber of Commerce Membership Form