Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

Reason(s) For Joining (Networking, Marketing, Advocacy, Workforce, Other):

Minority Owned (self identified) Yes/No: *

Women Owned (self identified) Yes/No: *

Veteran Owned (self identified) Yes/No: *

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

General: Please contact us to determine the fee.
Please contact the Chamber for membership prices. 507-288-1122.

Additional Fees:

Application Fee : $35.00
A $35 application processing fee will be added to your membership investment.

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address