NEW MEMBER APPLICATION

Lyndhurst, Seeley’s Bay & District Chamber of Commerce - Membership Application (new members)

To apply for membership please complete all sections. Your application will be reviewed and you will be notified of acceptance. Payment will be required upon acceptance as per invoice.
Name*

First NameLast Name
E-mail - This will be the primary email contact for news, offers, and notifications*

Confirmation Emailexample@example.com
Home Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

BUSINESS INFORMATION

Please complete for each business owned by you
Business 1 - Name
Business Name
Business 1 - Category
Business 1 - Short Description
Briefly Describe your service and/or product
Business 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email

Confirmation Emailexample@example.com
WEBSITE
SOCIAL MEDIA
Additional Businesses

Only complete if you are registering additional businesses owned by you
Business 2 - Name
Business 2 Name
Business 2 - Category
Business 2 - Short Description
Briefly Describe your service and/or product
Business 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email

Confirmation Emailexample@example.com
WEBSITE
SOCIAL MEDIA
Business 3 - Name
Business Name
Business 3 - Category
Business 3 - Short Description
Briefly Describe your service and/or product
Business 3 - Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
WEBSITE
SOCIAL MEDIA
Please provide any additional businesses information here. Or expand on your product and services

ADVERTISING

Your membership fee automatically includes free social media and website advertising, as well as promotion by the Chamber at all events, trade shows or business showcases. We will advertise for YOU, our valued members!
FacebookInstagramChamber Website
Text Listing OnlyBusiness Card Advert - note if this option is selected, a separate Advertising form will be forwarded to you with details of requirements and fees.

MEMBERSHIP AGREEMENT
I understand that by submitting this form I have read and agree to the membership agreement.*

First NameLast Name
Date*

DayMonthYear
Date
Should be Empty:

Lyndhurst, Seeley’s Bay & District Chamber of Commerce - Membership Application (new members)