Payments form - Credit Card: Greenville-Pitt Chamber of Commerce

Chamber Membership (Credit Card)

Application Form

Join the Chamber

Complete your membership application and payment information below.

Business Information

Business Name

Physical Address

City, State, ZIP

Mailing Address if different

Business Email

Business Phone

Fax

Website

Type of Business

Referred by

Primary Contact

Name

Phone

Secondary Contact

Name

Phone

Additional Contacts

Name

Phone

Additional Business Information

Full-Time Employees

Part-Time Employees

Other

Minority Owned Woman Owned

Brief Business Description

Company Logo JPG, PNG, or WebP, maximum 5 MB

Membership Level

Choose one membership level. Membership amounts and application fees are shown separately below.

Partner Membership: $375.00 Application fee: $35.00 Total: $410.00 Builder Membership: $675.00 Application fee: $35.00 Total: $710.00 Leader Membership: $1,325.00 Application fee: $35.00 Total: $1,360.00 Executive Membership: $2,500.00 Application fee: $35.00 Total: $2,535.00 President's Club Membership: $5,000.00 Application fee: $35.00 Total: $5,035.00 Chairman's Cabinet Membership: $10,000.00 Application fee: $35.00 Total: $10,035.00

Payment Information

Card Type *

Name on Card *

Billing Address *

City *

State *

ZIP *

Card Number *

Expiration Month *

Expiration Year *

Security Code *

Security Check

Complete the security check before submitting your application.

Greater Greenville Chamber

Contact Info

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Chamber Membership (Credit Card)

Application Form

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