Member

Member Application

The Sequim-Dungeness Valley Chamber of Commerce welcomes you! Our mission is to actively promote, educate and support the business community, to maximize a healthy economy and provide community leadership.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (600 char max): *

Directory Category: *

Employees:

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

I would prefer not to receive the yearly membership plaque:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Contact Preference:

Email Phone

Password:

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Membership Dues: $195.00
BRONZE Connector Membership Dues: $295.00
SILVER Promoter Membership Dues : $595.00
GOLD Engager Membership Dues : $1,095.00
PLATINUM PREMIER Partner Membership Dues: $100.00
Individual - Non Business Membership

Additional Fees:

Administration Fee : $25.00
One time application fee

Payment Option:

Charge my credit or debit card