Member - Membership

Please complete the registration form below. Once you have completed it you may choose the payment options below and pay with a credit or debit card. If you would prefer to send us a check please complete the application and mail a check to Gulfport Merchants Chamber - Membership, 3101 Beach Blvd S #1 Gulfport, FL 33707

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (500 char max): *

Directory Category: *

Employees:

Full-time Part-time

Comments / Questions:

Referred By Member:

Referred By Sales Person:

Preferred Payment Method: *

Please Enter Other Categories That You Want To Be Included In:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Phone:

Email:

Contact Preference:

Email Phone

Password: *

Membership Options

Membership Package: *

Non-Profit/Member - 2018: $10.00
Fee is for remainder of 2018. Level 1 Membership 1-10 employees - 2018: $30.00
Fee is for remainder of 2018. Level 3 Membership Franchise/Chain/Corporate - 2018: $125.00
Franchise fee is for remainder of 2018.

Additional Opportunities:

We will contact you with additional information.

Chamber Volunteer Opportunities : $0.00
Are you interested in volunteering your time for Chamber events? Hosting a Monthly Mixer : $0.00
Mixers are a great way to network and meet other business owners. Please select this option if you would like to host a mixer. Membership Committee : $0.00
Please select this option if you would like to be on the membership committee.

Payment Option:

Bill me Charge my credit or debit card

Print Application

Member Application

Mailing Address