MEMBERSHIP FORM – BLANCHARD, OK CHAMBER OF COMMERCE

BUSINESS NAME *

MAILING ADDRESS *

PHYSICAL ADDRESS (if different) *

WEBSITE ADDRESS *

BUSINESS PHONE NUMBER *

BUSINESS FAX NUMBER

CELL PHONE NUMBER

EMAIL ADDRESS *

MEMBERSHIP LEVEL *

NON-PROFIT - INDIVIDUAL ($50/year)
BASIC ($150/year)
GOLD ($500/year)
PLATINUM ($800/year)

Bi-annual billing is available for Basic, Gold & Platinum membership levels. Credit Cards are accepted for payment (MasterCard - Visa - Discover) Please call for payment assistance with bi-annual billing or credit card payments. Membership effective through the calendar year, January 1 - December 31.

BUSINESS CATEGORY

If your business does not fit in one of these categories - choose uncategorized and we can make a category for your business.

TELL US ABOUT YOUR BUSINESS

Name