New Membership Application

Business Information

Business Organization:

Mailing Address:

Street Address Address Line 2 City State ZIP / Postal Code

Phone:

Cell Phone:

Social Media Sites:

Business Website:

Please Provide a brief description of your business:

Chamber Bucks

We will accept Chamber Bucks!

Joining the Weatherford Chamber is a one-year commitment

Primary Representative listed as the main contact

Primary Contact Name:

Primary Contact Title:

Primary Contact Email:

Secondary Representative - Will also receive Chamber Communication

Secondary Contact Name:

Secondary Contact Title:

Secondary Contact Email:

Membership Levels

Select Membership Level

Platinum - $1,150

Gold - $625

Silver - $350

Non-Profi t - $200

Individual - $200

Stores Without Doors - $200

Retired Patron - $50

Payment Options

Check (payable to Weatherford Chamber of Commerce)

Mastercard/VISA/American Express/Discover

Signature

Date

MM slash DD slash YYYY

Consent

I understand that by providing my mailing address, email address, telephone number I consent to receive communications sent by, or on behalf of the Weatherford Chamber of Commerce (and its subsidiaries and/or affiliates) via regular mail, email, or telephone.