Member Application

Thank you for your interest in the Effingham County Chamber of Commerce! Please complete the application below and submit. A Chamber staff member will contact you shortly to find out how we can help you make the most of your Chamber membership.

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Info

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website *

Please add your company website.

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

LinkedIn

Facebook

Twitter

Step 2:

Additional Info

Business Description

Business Keywords (enter a space between words)

Directory Category *

Please select a directory category.

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

I am joining the Chamber for.. *

Looks good!

I was referred to the Chamber by

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

City

State

Postal Code

Country

Create Account

Login *

Please add your login username.

Password *

Please add your login password.

Step 4:

Billing Information

Same as Primary Contact

First Name

Last Name

Title

Phone

Email

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

City

State

Postal Code

Country

Create Account

Password

Step 5:

Membership Package

Please select a Membership Package

Connect Level

Grow Level

Influence Level

Contact Becky Brown, Membership Director, for assistance in completing your membership application.

Please call (217) 342-4147 or email bbrown@effinghamcountychamber.com

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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