Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Facebook

Step 2:

Additional Info

Business Description (200 char max) *

Please add your company description.

Directory Category

Full-time Employees

Part-time Employees

Community Welcome Program

Section Header

Group Insurance

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Facebook

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

Province *

Please add your Province.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Step 5:

Membership Package

Please select a Membership Package

20 Employees or more $ 525

11 to 20 Employees $ 315

6 to 10 Employees $ 210

Up to 5 Employees $ 105

Sole Proprietor $ 57.75

Individual, Non-profit, Non-business $ 57.75

Altona & District Chamber of Commerce Annual Membership

Comments/Questions

Payment Option

Bill Me

Please complete the Captcha

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Social Network Addresses

Step 4:

Billing Contact

Address

Social Network Addresses

Step 5:

Membership Package

Payment Option