FCHCC Membership Application (Payment by Check or Money Order)

FCHCC Membership Application (Payment by Check or Money Order)

Complete the membership application below. With this application you'll be able to choose if you are joining FCHCC for the first time or renewing your membership with a check or money order. Required fields are marked with a red (*) asterisk. Note: you do not have to be of Hispanic ancestry to volunteer for our committees.
Contact Name:*

First NameLast Name
Are you Joining as a New Member or Renewing your existing membership?*

I am joining FCHCC as a new member.I am an active member and wish to renew my membership.
Company Name:
Contact's Job Title:
No. of Employees:
If applicable, what date did your business start? FCHCC would love to celebrate your business anniversary with a "shout-out" on our Social Media Outlets!

MonthDayYear
If applicable, what type of products or services does your organization offers?
Is this a certified minority and/or disadvantaged-owned business?*

Minority-ownedWomen-ownedBoth Minority- & Women-ownedDoes not Apply
Organization that provided certification?
Principal/CEO or Owner's Birthdate (select Month):*
Principal/CEO or Owner's Birthdate (select Day):*
Annual Revenue of your Organization (if you are joining as a company):

up to $500K$501K - $1Mgreater than $1M
Select the industry for your Organization (if you are joining as a company):
If your organization is in a different industry, please specify (if you are joining as a company):
Address: (Please note: if you are joining FCHCC as a student or individual member, only your name will be displayed in the membership directory.) *

Street Address

Street Address Line 2

CityState

Postal/Zip CodeCountry
Does your Company have a logo? If so, you can upload it to have the chamber help promote your business. NOTE: this service only applies to Non-Profit 1 up to Strategic Partner membership levels.

Acceptable file formats: .jpg, .jpeg, or .png only.
Cancelof
Business Phone:*
Cell Phone:*
Business Fax #:
Have you ever served in the Armed Forces?*

YesNo
Do we have your permission to text you alerts where needed? (We take your privacy seriously so please be assured that we will not share your number with any third parties, nor overuse it).*

YesNo
Contact Email Address: (must be a working email): Please NOTE: Your email will be added to our email list so that you'll receive our monthly newsletter and event invites. You can opt out at any time.*

Confirmation EmailAlso note: if you've already subscribed, you won't be added to our list again, thank you for your support!
Website Address:
How did you hear about FCHCC?
COMMUNICATIONS
Are you on Social Media, ex. Facebook, X (formerly Twitter), Instagram and/or LinkedIn? Please select all that apply:*

FacebookX (formerly Twitter)InstagramLinkedInNot on social media
Your Facebook username or link:
X (formerly Twitter) username or link:
Instagram username or link:
LinkedIn username or link:
VOLUNTEER FOR FCHCC COMMITTEES
Serving on a committee provides a great opportunity to give back to the community, network, and enhance your leadership skills. Select a committee in which you would like to volunteer for. (Check all that apply.)

MembershipPrograms and EventsMarketing/MediaCultural CommitteeATD ScholarshipNon-ProfitSponsorship
MEMBERSHIP LEVELS

IMPORTANT: Membership dues are renewed annually. You will receive an email reminder notification prior to your membership expiration date and an invoice will follow.
AN IMPORTANT NOTE ABOUT INDIVIDUAL and STUDENT MEMBERSHIP LEVELS: If you are joining FCHCC as an individual or student member, these levels do not come with corporate-level member benefits (i.e., opportunity to be a guest on FCHCC Al Aire radio show or business information listed in the Members directory).*

I Acknowledge that I have read and understand the information above about my joining as an Individual or Student Member.Not Applicable; I am not joining FCHCC as an Individual or Student Member.
If you're joining as a student, what university or educational institution are you enrolled in?
Please select the desired membership level below: (NOTE: a credit card processing fee will be added at checkout.)*

Strategic Partner - $10,000Leadership Trustee - $5,000Large Corporation #2 (1,001+ employees) - $2,500Large Corporation #1 (100 - 1,000 employees) - $1,500Small Business #1 (49 or less employees) - $300Non-Profit #3 Organization 501 (c)3 (76+ employees) - $800Non-Profit #2 Organization 501 (c)3 (26 - 75 employees) - $400Non-Profit #1 Organization 501 (c)3 (25 or less employees) - $200Individual Member (Not representing a company!) - $150Student Member - $25
Please verify that you are human*
Make all checks and/or money orders payable to:

First Coast Hispanic Chamber of Commerce or (Hispanic American Business Association of NE FL); P.O. Box 57972; Jacksonville, FL 32241
Should be Empty:

FCHCC Membership Application (Payment by Check or Money Order)

COMMUNICATIONS

VOLUNTEER FOR FCHCC COMMITTEES

MEMBERSHIP LEVELS

Make all checks and/or money orders payable to: