Member Application

Thank you for your investment in the DeForest Area Chamber of Commerce. Our vision is to be the leader in providing advocacy, education, promotion and vitality to businesses and organizations in the DeForest area community.

Step 1:

Member Info

Company Name * required

Please add your company name.

Phone * required

Please add your company phone number.

Website * required

Please add your company website.

Email * required

Please add a valid email.

Physical Address

Address line 1 * required

Please add your address.

Address line 2

Country * required

Please add your country.

City * required

Please add your City.

State * required

Please add your State.

Postal Code * required

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1 * required

Please add your address.

Address line 2

Country * required

Please add your country.

City * required

Please add your City.

State * required

Please add your State.

Postal Code * required

Please add your Postal Code.

Social Network Addresses

Facebook

Instagram

Step 2:

Additional Info

Business Description (200 char max)

Business Keywords (enter a space between words)

Directory Category * required

Please select a directory category.

Full-time Employees * required

Please add your number of full-time employees.

Part-time Employees * required

Please add your number of part-time employees.

Step 3:

Primary Contact

First Name * required

Please add your first name.

Last Name * required

Please add your last name.

Title * required

Please add your title.

Phone * required

Please add your phone number.

Cell Phone

Fax

Email * required

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

Country

City

State

Postal Code

Facebook

Instagram

Create Account

Password * required

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Fax

Contact Preference

Phone

Address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Create Account

Password

Step 5:

Comments/Questions

Payment Option

Bill Me

Please complete the Captcha

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

Social Network Addresses

Create Account

Step 4:

Billing Contact

Address

Social Network Addresses

Create Account

Step 5:

Payment Option

Advocate. Educate. Promote.