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Flagstaff Chamber of Commerce

Member Application

THANK YOU for your interest in joining the Flagstaff Chamber of Commerce! Membership is open to all businesses, organizations and individuals who maintain a voluntary annual dues investment and who have an interest in doing business in the greater Flagstaff area.

Business Information

Company Name: *

Phone: *

Website:

Email: *

Business Description (200 char max):

Business Category: *

Employees: *

Full-time Part-time

Business Keywords:

Keyword 1 Keyword 2 Keyword 3 Keyword 4 Keyword 5 Keyword 6 Keyword 7 Keyword 8

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State / Province:

ZIP / Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login:

Password:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Company Address

Line 1: *

Line 2

City: *

State / Province: *

Zip / Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Contact Preference:

Email Phone

Login:

Password:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

ZIP / Postal Code:

Country:

Membership Options

Membership Package: *

Membership Dues: See fee schedule to determine the fee and enter it below.
If using fee schedule, enter fee here:

Additional Fees:

New Member Processing Fee
This $25 fee allows the Chamber to input the application for membership into the database and other applicable areas based on the type of membership.

Payment Option:

Charge my credit card

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 7 plus 5?: *

Print Application

© Flagstaff Chamber of Commerce | 101 W. Route 66 • Flagstaff, AZ • 86001 | Phone: 928.774.4505 • Fax: 928.779.1209
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