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New Member Application

 
Welcome to the Brentwood Chamber of Commerce!
 

Member Application:

* Company Name:  
* Phone:  
Website:
* Email:
* Business Description (200 char max)
Business Keywords: (enter a space between words)
 
* Physical Address:  
* City/State/ZIP:  
Country:
 
* Mailing Address: Same as physical address
* City/State/ZIP:
Country:
 
* Business Category:
Employees: Full-time:      Part-time: 
Comments/Questions:
 
 

Primary Contact Information:

* Name (First / Last):  /   
Title:  
* Phone:  
Cell Phone:
Fax:
* Email:  
Contact Preference: Email  Phone
* Login:
* Password:
 
Social Networking: LinkedIn:
Facebook:
 
* Address: Same as Member Address
* City/State/ZIP:
Country:
 
 

Billing Contact Information:

Same as Primary Contact
* Name (First / Last):  /   
Title:  
* Phone:  
Cell Phone:
Fax:
* Email:  
Contact Preference: Email  Phone
* Login:
* Password:
 
Social Networking: LinkedIn:
Facebook:
 
* Address: Same as Member Address
* City/State/ZIP:
Country:
 
 
Membership Package:
Employees 1-2: $210.00
Any business with one or two full-time equivalent employees, including sole proprietorships.
Employees 3-10: $260.00
Any business with three to ten full-time equivalent level employees.
Employees 11-20: $365.00
Any business with 11 to 20 full-time equivalent employees.
Employees 21-30: $450.00
Any business with 21 to 30 full-time equivalent employees.
Employees 31-50: $500.00
Any business with 31 to 50 full-time equivalent employees.
Employees 51-75: $575.00
Any business with 51 to 75 full-time equivalent employees.
Employees 76-100: $625.00
Any business with 76 to 100 full-time equivalent employees.
Employees 101-200: $675.00
Any business with 101 to 200 full-time equivalent employees.
Employees over 201: $0.00
Please call Chamber for specific pricing.
Non-Business Associate Member: $105.00
Charitable organizations, Government officials, educators, interested citizens and retired individuals.
Additional Fees:
New Member Administrative Fee $25: $25.00
One-time only set up fee.
Payment Option:
Charge my credit or debit card
 
 
Submit Application:
Enter the CAPTCHA answer, then press the Submit Application button.
What is the sum of 2 plus 6?
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