Membership Application Form

Join the Bridgeton Area Chamber of Commerce - Invest in Your Business and the Chamber

To apply for membership please complete as much of the requested information as possible so we can add you, your business and organization correctly to our databases and websites.
PUBLIC INFORMATION SECTION

Information in this section will be provided to the public to contact your business / organization. If you have contact information you want us to use that is not for public use, put that in the non-public section later in this form.
Business or Organization Name *
Main Public Contact Person for This Membership 1 *

First Name Last Name
Main Public Email 1 *

Public Address - Usually Physical Address of the Business *

Street Address
Street Address Line 2
City	State
Postal / Zip Code	Country

Municipality in Which Your Business or Organization is Located *
Public Phone(s) for Sales and Information - Include Area Code
Phone(s( for Main Contact Person if Different from Public Phone - Include Area Code
Fax Number - Include Area Code
Website
Social Media Link 1
Social Media Link 2
Type or General Category of Your Business or Organization *
Brief Description of Your Business / Organization - Products, services, specialties *

0/50
Please let us know if someone recommended the Chamber or referred you to the Chamber
Additional Information Including Additional Contacts, Billing Address and Private Data
Are There Additional People in the Organization Who Should Receive Chamber Communications?

Yes No
Additional Contact Person for This Membership 2

First Name Last Name
Additional Contact Email 2
Additional Contact Person for This Membership 3

First Name Last Name
Additional Contact Person Email 3
Do you have another address you want to provide to the Chamber

Billing address, contact info., different from address provided near the start of this application, for Chamber use but not publc use. Mailing address, contact info,.different from the one provided at the start of this application, for Chamber use but not public use.
Additional Contact Name for Billing - For Chamber not public use.

First Name Last Name

Additional Email Address fro Billing Purposes
Additional Contact Name - For Chamber not public use.

First Name Last Name

Additional Email Address - for Chamber not public use
How Many Full-Time Equivalent Employees Does the Business / Organization Have *
How Will You Pay the Membership Investment in the Chamber? After selection of payment option, a section will open BELOW THIS SECTION to allow you to select your fee based on number of FTE employees.. *

Will mail or deliver check to the Chamber office Will deliver cash to the Chamber office Will pay in full in one payment Will pay in three payments. Will pay online via debit, credit or PayPal Will call the Chamber office to authorize credit card payment. Note for security reasons, do not put your credit card information on this application. Please send invoice for this investment
PAYING WITH CASH OR CHECK OR CALLING THE OFFICE TO MAKE CREDIT CARD PAYMENT BY PHONE - Select the Amount of the Fee for Your Chamber Membership - FTE means Full Time Equivalent *
PAYING ONLINE WITH DEBIT. CREDIT OR PAYPAL - Membership Fee - Complete this section to pay now online with debit, credit or PayPal.. When using this section, when you click apply for membership at the end of the form, in a few seconds, the checkout area will open for your use.

Individual membership - no company or organization $ 135.00

Owner only employee $ 135.00

Not-for-profit organization with 25 FTE employees or less. For not for profits with 26 or more FTE employees, normal investments apply. $ 150.00

1-5 FTE Employees $ 200.00

6-25 FTE Employees $ 230.00

26-50 FTE Employees $ 265.00

51-100 FTE Employees $ 340.00

All Financial Institutions - Any number of employees $ 340.00

101-150 FTE Employees $ 410.00

151-200 FTE Employees $ 485.00

201-250 FTE Employees $ 540.00

251-300 FTE Employees $ 600.00

More than 300 FTE Employees $ 750.00
Date of Applicatoin
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Join the Bridgeton Area Chamber of Commerce - Invest in Your Business and the Chamber