Member

Thank you for your interest in the Birch Bay Chamber of Commerce. We are excited to have you on our team!

Business Information

Company Name: *

Leave Blank:

Phone: *

Website: *

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

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: *

Social Networking:

LinkedIn Facebook Instagram Twitter You Tube

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Instagram Twitter You Tube

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: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Instagram Twitter You Tube

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Corporation / 50+ Employees: $525.00
Large Business 11 - 49 Employees: $300.00
Medium Business 5-10 Employees: $200.00
Small Business 2-4 Employees: $150.00
Self Employed Individual Membership: $125.00
Not For Profit / Municipal Organization: $100.00
Associate/Community Member: $50.00

Payment Option:

Bill me Charge my credit or debit card

Print Application

Member Application

Mailing Address

Address

Address