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Member Application

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Contact

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Leave Blank

Phone *

Please add your company phone number.

Website *

Please add your company website.

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Step 2:

Additional Info

Business Description (200 char max) *

Please add your company description.

Directory Category *

Please select a directory category.

Full-time Employees

Part-time Employees

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

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

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

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Primary Contact Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Step 5:

Membership Package

Please select a Membership Package

Non-Profit $175

Business Anchor $250

Community Anchor $500

Bronze Anchor $750

Silver Anchor $1,000

Gold Anchor $2,000

Platinum Anchor $3,500

Diamond Anchor $5,000

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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Bremerton Chamber of Commerce | 409 Pacific Avenue Suite 207, Bremerton, WA 98337 | (360) 479-3579 | [email protected]

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