Membership Form - Washburn Chamber of Commerce

Business Name*

Contact Name

First Last

Title

Number of FTE's including owners*

Number of Years in Business*

Does your Business Rely on Tourism?*

Yes

Demographic Information*

Family-Owned

Woman-Owned

Minority-Owned

Disabled-Owned

LGBTQ+ Owned

55+ Owned

Veteran-Owned

None of the Above

We use this information to apply for grants, & to connect you with resources & funding opportunities.

Business Address

Street Address Address Line 2 City State ZIP Code

Shipping Address

Same as Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Business Phone*

This is shared on our website and in the visitor guide.

Additional Phone

Cell Phone

Website URL

Please include https:// before your address or the system will not accept it.

General Email Address*

This will be shared with the public on the website.

Contact Email Address*

This will only be used for communication by the chamber

Names and Emails of Additional Employees who Should Receive Chamber Communications

Please make these people aware that you want them to receive these communication.

How do you prefer to be contacted?*

Phone

Mail

Text

Social Media Messenger

Other

If other please let us know in the comment section below how you prefer to be contacted

Facebook URL

Instagram URL

Google Business URL

Other Social Media URL's

Category – Please choose 1*

This is how you will be listed in the visitor guide & on the website.

Please describe your listing*

Do we have your current logo?*

Yes

We will be in touch once payment is received to collect additional photos and content to add to your page on our website if needed.

How can we best support you? – Select all that apply*

I am a small business & I want more foot trafic.

I need to build my network & learn about business strategy.

I need the chamber to advocate & provide tools to strengthen my industry in the region.

We need support & connections to fufill our mission.

I need to grow my brand visibility with the community

Other – I have made notes in the comment section below.

N/A

Educational Opportunities – Select all that apply*

I need training for myself.

I need training for my employees.

I need training for my volunteers.

I would like to maximize my membership! Let me know when the next Chamber 101 takes place.

N/A

What trainings would you like to see? What would you like to learn about?

Sponsorship Opportunities – Select all that apply

Please check the boxes of the events & activities you would be interested in supporting this year. We will be in touch!

Comments/questions regarding membership. Extended answers to anything above.

Membership Options*

NON-PROFIT No Employees – $130

NON-PROFIT With Employees – $170

NON-PROFIT Education, Healthare, or Government – $210

Home-Based Business (excludes lodging) ≤ 2 Employees – $130

≤ 2 Employees – $170

3-10 Employees – $210

10+ Employees – $230

Chamber Investor

Total

Payment Method*