Member - DEMO - Deon's Demo Database, MN

Member Application

Welcome, and thank you for your interest in the Green Valley Chamber. To apply for membership, or request follow-up by Chamber staff, please fill out the information below and a member of our team will contact you. Please note that when you make an application for membership in the Green Valley Chamber you are acknowledging you have received and will maintain all licensing required and accreditation's being promoted. You pay all required and applicable taxes, and the information disclosed on the application is reflected accurately. Membership investment in the Green Valley Chamber may be tax deductible as an ordinary and necessary business expense, but not as a charitable tax deduction for federal income tax purposes.
Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Directory Category:

Employees:

Full-time Part-time

Sales Rep: *

HQ_ZIP: *

Employer: *

Chapter:

Principle Product/Service:

No. of Trucks in Oregon:

Membership Classification *Check all categories that apply (required):

TL Carrier:

Common Carrier:

Log Truck:

Pick your catagory: :

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: *

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

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:

Email:

Contact Preference:

Email Phone

Login:

Password:

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Fee Descriptions: See fee schedule to determine the fee and enter it below.
See a complete fee breakdown General Membership: $265.00 : $265.00
1-10 employees General Membership: $315.00 : $315.00
11-20 employees General Membership: $365.00 : $365.00
21-30 employees General Membership : $415.00 : $415.00
31-45 employees Food Vendor: $165.00: $165.00
Food Vendor Professional Individual: Please contact us to determine the fee. :
Realtors, Sales Consultant, Insurance Agents Non Profit: $105.00 : $105.00
Non Profit Association/Organization If using fee schedule, enter fee here:

Additional Opportunities:

We will contact you with additional information.

Gold Package : $500.00
Includes 1 year banner ads, advanced business directory, 3 event tickets, sponsor logo 3 events. Silver Package : $250.00
Includes advanced business directory, 2 event tickets, 2 event sponsor logos. Bronze Package : $100.00
Includes 1 event ticket and an advanced business directory.

Payment Option:

Bill me Charge my credit or debit card

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