561-659-0285

Join the Chamber

New Member Application
(*) Denotes Required Fields
Company Information
Company: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Web Site:
Online Links:
Business Category #1:
Please contact us with questions regarding business categories.
Full-time Employees:
Part-time Employees:
Members-only Access
Members-only allows you to update your information online via a secure login.
Admin E-mail: *
Password: *
Verify Password: *
Primary Contact Person
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Billing Contact Person
Prefix:
First Name: *
Last Name: *
Suffix:
Familiar Name:
Title:
Address Line 1: *
Address Line 2:
City: *
State: *
Zip: *
Phone 1: *
Phone 2:
Fax:
E-mail: *
Additional Business Information
Referred by:
Membership Investment Structure
Contact the WCC office for details.
Regular Memberships
One Member Representative$225.00
Two Member Representatives$350.00
Three Member Representatives$475.00
Four Member Representatives$650.00
Five Member Representatives$950.00
Other Membership Levels & Dues
1 Member Representative$175.00
Additional Representatives: x $50.00$175.00
$225.00
$50.00
__________
Total:$225.00
(*) Denotes Required Fields