Application

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Basic Member Information:
Company Name
Individual Representative First Name
Individual Representative Last Name
Title
Number of Employees
Main category listing in Directory
Mailing Address
City
State
Zip
Physical Address (if different)
City
State
Zip
Preferred address for Directory/Website
Website address
E-Mail address
Phone
Cell
Fax
Referred by
What do you expect from your investment in the Uptown Chamber of Commerce? Check all that apply.   Access Business Opportunities
  Create Visibility
  Expand Networking Opportunities
  Increase Revenue
  Enhance Credibility & Business Identity
  Learn the Best Business Practices
  Community Involvement
  Other  
 
Determine your Membership Investment Level (* indicates voting rights)
Business Basic* (based on number of employees/agents)
Not-for-Profit* (based on number of employees/agents)
Trustee Level*
 $1,700
Diamond Level*
 $1,100
Emerald Level*
 $550
Home-based Business*
no employees (single owner-occupational license required for discount)*		 $150
Service Organization
(no employees - volunteer driven)		 $100
Friend of the Uptown Chamber
offered to any individual who would like to be personally involved, including clergy, government employees or officials, an individual who is not engaged in a gainful occupation (i.e. retired) or any person elected by the Board for special service to the Chamber.		 $100
A New Member application fee of $25.00 will automatically be added to your total.
 
Additional Representative's Name
Title
E-Mail Address
Phone
Fax
Additional Category:
A second category listing for your business in the membership directory. (i.e. Original listing - Accounting, additional listing - Tax Preparation)		 $25  
Prepaid Luncheon Package:
Member luncheons are held on the 3rd Wednesday of the month and are a great way to network and promote your business. Members are encouraged to bring business cards and brochures. Cost is $18 per month. Special Pre-pay $180 Eleven lunches (get one month free, Annual Installation dinner not included)		 $180
 
Payment Options
Pay By  
 Credit Card Number    
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Email Address
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CATALYST  |  CONNECTOR  | CONVEnER

 Uptown Chamber of Commerce.  All Rights Reserved.
9385 N. 56th Street, Suite 101  | Temple Terrace, FL 33617
Phone: (813) 989-7004  info@uptownchamber.org