Member - PublicLayout - Chamber of Commerce of Okeechobee County,FL

Business Information

Company Name: *

Phone: *

Website:

Email: *

Business Description (200 char max):

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Physical Address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

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Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Friends: $50.00
Friends of the Chamber (Non-Voting) NP: $100.00
Non-Profit (Non-Voting) Tier 1: $200.00
1-10 Employees Tier 2: $300.00
11-30 Employees Tier 3: $500.00
31+ Employees Corp: $1,000.00
Corporate Member

Payment Option:

Charge my credit or debit card

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