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Monticello-Wayne County Chamber of Commerce Membership Application
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* Indicates required question
Type of Organization/Business
*
Non-Profit Organization
Individual (no business affiliation)
Industrial, Health, Retail 1-10 Employees
Industrial, Health, Retail 11-50 Employees
Industrial, Health, Retail 51-100 Employees
Industrial, Health, Retail 101+ Employees
Civic Organization
Bank
City/County Government entity
Dock/Lodging
Insurance Agent/ Real Estate Broker
Media
Utilities
School
Other (Contact Board for Special Consideration)
Required
Is this a new membership or a renewal?
*
New Member
Renewal
If you are a new member, Do you want to be contacted regarding the following?
*
Ribbon Cutting at your location
Grand Opening Event support
Other - Please provide details in the provided space at the end of the application.
Chamber Ambassador
Required
Business Name
*
Your answer
Contact person for Public Inquiries
*
Your answer
Location address
*
Your answer
Mailing address (If different)
Your answer
Telephone
*
Your answer
Email
*
Your answer
Do you want the email shared with the public on our website?
*
Yes
No
Email address for invoicing purposes (if different)
*
Your answer
Website address
*
Your answer
Any promotional notes or things we need to know? (We use this information for social media and other promotions, so please include anything you think would be beneficial for that.)
*
Your answer
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