Member

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Twitter

YouTube

Instagram

GooglePlus

Step 2:

Additional Info

Business Description (200 char max)

Business Keywords (enter a space between words)

Directory Category

Full-time Employees

Part-time Employees

Minority Owned

Woman Owned

Veteran Owned

LGBTQ+ Owned

Do not publish my address

Select the WDM Chamber Rep who is working with you: *

Looks good!

Where is your business located?

Were You Referred by a Current WDM Chamber Member? If so, please list their name below:

Primary Organziation Contacts

Human Resources Leader

Human Resources Leader Email

Marketing Leader

Marketing Leader Email

Sales Leader

Sales Leader Email

Owner/Founder/CEO

Owner/Founder/CEO Email

Optional Information to Share with WDM Chamber

How do you set yourself apart from your competition?

What do customers like most about your product/service?

What are your organizational goals for the next two or three years?

What changing demographic or cultural trends are having a significant impact on your company?

What issues are on the horizon for your/our industry that we should be aware of or thinking about?

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Create Account

Password *

Please add your login password.

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Create Account

Step 5:

Membership Package

Payment Option