Membership Form – Chase City Chamber of Commerce

Here’s where the magic happens! The information you provide here will be used to create your unique business directory listing, so please be thorough and creative!

This form is for NEW members. If you are already a member, please use the renewal form.
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* = Required

Business Details

Business Name *

Business Category *

Business Description

Business Logo

Billing Address *

City *

State/Province *

Zip/Postal Code *

Country *

Email *

Phone Number *

Use this billing address as my business address.

New Membership or RenewingPlease indicate if this is a NEW Membership or a RENEWING Membership

Select Membership Level and Pay

Membership Level *

Processing Fee

Total Due:

Payment Method: PayPal
Check

Terms & Conditions Statement: Data submitted through this form will be used for the purpose of creating your directory listing. Please see our Privacy Policy for more information on how we protect and manage your data.