Membership Application
The Blackstone Chamber of Commerce 
Office Location: 105 West Broad Street, Blackstone, VA 23824
Please send membership application checks to:
PO Box 295, Blackstone, VA 23824
Email: blackstonevachamber@gmail.com
Phone: (434) 294-0280
Sign in to Google to save your progress. Learn more
Email *
Name of Business/ Organization *
Contact Person *
Address *
Contact Phone Number *
Yearly Membership Cost
Memberships are for one year, January to December. Membership fees will be prorated based on the quarter a member joins. Renewal invoices are sent out in December for the upcoming year.  Please send payment check to The Blackstone Chamber of Commerce PO Box 295, Blackstone, VA 23824.
Select One Type of Membership  *
Business Classification for Directory *
Please select one category that fits your business description.
How can the Chamber help your business? *
Please check the benefits and services that led you to join.
Required
Please check all projects and areas that you are interested in participating or assisting in.  *
Required
Applicant Signature *
By typing your name below you are completing  The Blackstone Chamber of Commerce Membership Application. 
Date of Signature
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms