Membership Application Form

2024-25 Membership Application

To apply for membership please complete all questions. Unless otherwise requested, ALL information will be used to advertise your business on the Chamber's web site. The Chamber's membership years runs June 1 - May 31. Payments by check can be mailed to: SRCC PO Box 1008 Steinhatchee, FL 32359
Date*

MonthDayYear
Business Name*
(The name people will recognize, not necessarily your corporate name.)
Voting Designee*

First NameLast Name
Business Address (if you do not have a physical address, leave blank)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address*

Street Address

Street Address if different

CityState / Province

Postal / Zip Code
E-mail*
Contact Number*

Area CodePhone Number
Mobile Number - by supplying this number you agree to receive text messages

Area CodePhone Number
Website or Facebook Page
Full Name*

First NameLast Name
My Products*
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Business Membership $100.00

Additional Business Membership (Only check this box if you have already joined as one business. Each business requires a separate application.)$50.00

Patron Membership$25.00

Total $0.00
Payment information: Once you select submit, a new screen will appear, giving you the option to pay via PayPal.
Choose the category that best describes your business. You may select multiple categories.

Boat & Repair Services/ RentalsBuilding Materials & Hardware SuppliesBusiness ServicesCharters & GuidesChurchConstructionGift ShopsGroceries & GasHair SalonsHomes Furnishings & AppliancesInsuranceMarinasMedical & PharmaceuticalOrganizationsProfessional ServicesRealty & Management ServicesResorts, Lodging & MotelsRestaurants & Bars & SpiritsRV Resorts & CampgroundsStorageVendors
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2024-25 Membership Application