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Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max):

Directory Category:

Employees:

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Join Reason: *

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: *

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

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:

Phone:

Cell Phone:

Email:

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Platinum Membership Investment: $5,000.00
https://www.benbrookchamber.org/elite-membership/ Gold Membership Investment: $4,000.00
https://www.benbrookchamber.org/elite-membership/ Silver Membership Investment: $3,000.00
https://www.benbrookchamber.org/elite-membership/ Bronze Membership Investment: $1,500.00
Copper Membership Investment: $750.00
Basic Membership Investment: $250.00
Non Profit Organization: $150.00
Organizations classified as not for profit according to the federal government.

Additional Opportunities:

We will contact you with additional information.

Basic Enhanced Listing Package : $150.00
Stand Out! Corporate Logo; Preferred Placement; Business Description Additional Characters; Bullet Points w/Links; 8 Photo Slide Show; and, One YouTube Video

Payment Option:

Charge my credit or debit card

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Member Application

Mailing Address

Address

Address