Interest Survey
We value your input! Please take a moment to share your interests with us.
Full Name
*
First Name
Last Name
Business Name
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Hosting a one-hour networking event at your business (up to 25 people)?
AM
PM
Not Interested
Hosting a monthly Luncheon event at your Church (up to 200 people-11am to 1pm)
Yes
No
Which membership are you most interested in?
Individual Membership
Business Membership
Founding Membership
Church Membership
Student/Retired
Are you interested in Board Membership?
Chairman
Co-Chairman
Treasureer
Secretary
General Board Member
Are you interested in participating on a Committee?
Finance Committee
Nomination Committee
Membership Committee
Program Committee
Marketing and Media Committee
Communication and PR Committee
Are you interested in becoming a Chamber Ambassador? (Represents Chamber at various events and functions)
Yes
No
Are you interested in being a Luncheon Speaker?
Yes
No
Sign up me up for Newsletter Updates!
Yes
No
Any additional comments or suggestions?
Submit
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