Membership Application | Brantford Brant Chamber of Commerce

Business Name *

Established In

Year

Month

Day

Business Type *

Please select which best applies.

Mailing Address

Street

City

Province

Postal Code

Physical Address (If different from above)

Street

City

Province

Postal Code

Other Information

Telephone

Toll Free

Fax

Website

Main Contact

Name

Position

Telephone

Ext.

As a measure of fiscal and environmental responsibility, the Chamber of Commerce utilizes electronic mailing as its primary means of communication with members, including invoicing, event notifications and other correspondence. To ensure information reaches the proper individuals, please provide the following information:

Membership Dues Contact

Name

Title

Tel and extension

Advertising Contact

Name

Title

Tel and extension

Events Contact

Name

Title

Tel and extension

The Chamber of Commerce often sends out electronic newsletters, notifications of upcoming events and other useful information to members listed in our e-notification database. If you wish to include any of the above personnel and others in this list, please provide their email addresses in the space below.

Email Address 1

Email Address 2

Email Address 3

Email Address 4

Number of Full-time Employees

Number of Part-time Employees

Directory Category

Additional categories may be purchased.

Sponsoring Business

If applicable

Expectations in joining

Areas of Interest

Check all that apply

Check your payment preference

Payment in full at sign-up

*Debit my bank account monthly

* Pre-authorized debiting from your account will occur on the 10th day of each month for 12 consecutive months. An annual service charge of $18 will apply - charged monthly in the amount of $1.50. Your initial payment will include admin fees totaling $55 - this reflects a one-time office admin fee of $45, and an annual Ontario Chamber admin fee of $10, after which, a monthly withdrawl will be made from your account on the 10th day of each month for eleven consecutive months.

About Your Membership:
Membership continues UNTIL REVOKED IN WRITING up to 30 days after the anniversary date, at which time your membership certificate must be returned to the Chamber office. Failure to return will result in a charge of $30.

Privacy Policy:
The Chamber DOES NOT distribute or sell electronic lists of its membership. In mass electronic communications with members, individual email addresses are not made visible to others.

Please Note: After this application has been submitted, our Business Development Coordinator will contact you to finalize the details of the application and to obtain your signature on the printed copy of the application. In signing, you are indicating that you have completed the application accurately and truthfully, and are authorizing the Chamber of Commerce to publish the information contained within this application in Chamber Directories, where applicable. Please ensure you have completed all sections of this application to avoid delays in processing.

Method of Payment