Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Facebook

Twitter

Instagram

Google+

YouTube

Vimeo

Yelp

Yellow Pages

Blog

Flickr

Step 2:

Additional Info

Business Description (1600 char max) *

Please add your company description.

Business Keywords * (enter a space between words)

Please add your business keywords.

Directory Category *

Please select a directory category.

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

How did you hear about the Chamber?

3 Things You Hope to get from joining the Chamber #1

3 Things You Hope to get from joining the Chamber #2

3 Things You Hope to get from joining the Chamber #3

Will you offer any discounts to other Chamber Members?

Would you like to make a donation to the GOVCC Chamber Foundation or the Steve Engle Memorial Scholarship Fund?

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password *

Please add your login password.

Step 5:

Membership Package

Please select a Membership Package

New Member Dues $ 300

1-5 employees

New Member Dues $ 360

6-15 employees

New Member Dues $ 475

16-30 employees

New Member Dues $ 575

31-60 employees

New Member Dues $ 775

61-100 employees

New Member Dues $ 1,075

101+ employees

Non Profit Dues $ 300

School/Church/NP Assn

Comments/Questions

Payment Option

Charge my credit or debit card

Please complete the Captcha

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Create Account

Step 5:

Membership Package

Payment Option