Member - Pacifica Chamber of Commerce - Pacifica Chamber of Commerce

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (200 char max):

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

Physical Address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

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Primary Contact Information

First Name: *

Last Name: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

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: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Sole Proprietor/Small Business 0-4 Employees: $295.00
Sole Proprietor/Small Business 0-4 Employees Small Business 5-9 Employees: $395.00
Small Business 5-9 Employees Medium Business 10-19 Employees: $495.00
Medium Business 10-19 Employees Large Business 20+ Employees: $545.00
Large Business 20+ Employees Non-Profit Organization: $205.00
Non-Profit Organization- Individual Home Based Business: $235.00
Individual sole proprietor working out of home. No employees. Individual Non Business, Non Voting: $145.00
Individual Non Business, Non Voting, "Friend of Chamber"

Additional Fees:

Processing Fee : $30.00
One-Time Processing Fee $30.00

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address