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:

Use Company contact information above.

Address Line 1:	*
	Address Line 1 or Line 2 required.
Address Line 2:
City:	**
State:	**
	Incorrect format for State (XX).
Zip:	**

Phone 1:	***
	Incorrect format for Area Code (###).
Phone 2:
	Incorrect format for Area Code (###).
Fax:
	Incorrect format for Area Code (###).
E-mail:	**

Billing Contact Person

Send bills to Primary Contact above.

Prefix:

First Name:

*

Last Name:

*

Suffix:

Familiar Name:

Title:

Use Company contact information above.

Address Line 1:	*
	Address Line 1 or Line 2 required.
Address Line 2:
City:	**
State:	**
	Incorrect format for State (XX).
Zip:	**

Phone 1:	***
	Incorrect format for Area Code (###).
Phone 2:
	Incorrect format for Area Code (###).
Fax:
	Incorrect format for Area Code (###).
E-mail:	**

Additional Business Information

Referred by:

Logo Link to your Website (additional $50.00)


**	$50.00

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Membership Investment Structure

Contact the WCC office for details.

Regular Memberships

Professional (1-5 employees)


	One Member Representative	$250.00

Small Business A (6-20 employees)


	Two Member Representatives	$350.00

Small Business B (21-50 employees)


	Three Member Representatives	$475.00

Small Business C (51-100 employees)


	Four Member Representatives	$650.00

Corporation (100+ employees)


	Five Member Representatives	$950.00

Other Membership Levels & Dues

NonProfit


	1 Member Representative	$195.00
	Additional Representatives: x $50.00	$195.00

Government


		$250.00

Institutional/Student


	Enrolled Student
	$50.00

	First Year Graduate
	$70.00

	1 Representative, 1 Student
	$250.00

	1 Representative, 3 Students
	$325.00

	2 Representatives, 2 Students
	$400.00

	2 Representatives, 3 Students
	$450.00

One-Time Processing Fee

$25.00

__________

Total:

$250.00

(*) Denotes Required Fields

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