Member - DeLand Area Chamber of Commerce, FL

DeLand Area Chamber and Orange City Business Alliance

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Member Application

Thank you for your interest in becoming a member of the DeLand Area Chamber of Commerce! Please complete the following member information.
Business Information

Company Name: *

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Phone: *

Website: *

Email: *

Business Description (200 char max):

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

Physical Address

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Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

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: *

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Financial Institution - Main Branch : $450.00
Financial Institution - additional Branch in Service Area : $225.00
Restaurant / Rental Property 1 - 50 seats: $280.00
Restaurant / Rental Property 51 - 100 seats: $315.00
Restaurant / Rental Property 100 seats: $350.00
General Business / Manufacturers 1 - 10 employees: $250.00
General Business / Manufacturers 11 - 25 employees: $300.00
General Business / Manufacturers 26 - 50 employees: $350.00
General Business / Manufacturers 51 - 75 employees: $400.00
General Business / Manufacturers 76 - 100 employees: $450.00
General Business / Manufacturers 100+ employees: Please contact us to determine the fee.
Special Categories - Non-Profit (501c3only): $150.00
Special Categories - Associate Member : $50.00
Special Categories - Homebased Business or Agricultural : $195.00

Payment Option:

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Member Application

Mailing Address

Address

Address