New Member Application – Matawan-Aberdeen Chamber of Commerce

Application Page 1 of 2

Please fill out the following information accurately. The information on the Join Form and this additional form will become your business listing in our directory and website. Where noted, please indicate if the information is to be displayed or not displayed in our directory online and in print.

If you would like to offer the members a discount, please indicate that below.

Business Name *

Main Business Phone *

Main Business Email *

Primary Business Contact Name *

First

Last

Primary Contact Title *

Primary Contact Email - (This is the email address for your contact person. Your main business email is entered on the next page. They can be the same if applicable.) *

Confirm Email

This is the email address for your contact person. Your main business email is entered on the next page.

Which Email Address do you want displayed on our Website? *

Main Business Email Address
Primary Contact Email
Neither
Both

Primary Contact Cell Number *

Can be different from the Main Business phone number, which you will provide on page 2 of this application.

Display Your Cell on Our Website *

Additional contact names and contact information (if applicable)

Physical Address *

Which Address do you want displayed on our website? *

Billing Address
Physical Address
Neither

Your Website

Would you like to provide a Member-to-Member Discount? Please select Yes or No from the dropdown menu below. *

Please Describe Your Member-to-Member Discount (Optional)

I am interested in further information on becoming involved with a committee and/or a volunteer opportunity

Check if yes

Referred by (if Applicable):

Submit questions or comments here

Phone