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CONTACT INFORMATION
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Company Name
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Physical Address
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City
State
Zip Code
Country
Main Contact Name
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First
Last
Main Contact Position
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Phone Number
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Email
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Mailing Address, if different from physical
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COMPANY INFORMATION
Business Industry
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Anniversary Date of Business
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Preferred Method of Receiving Information
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Text Message
Email
Mail
Would you like to offer a discount to other chamber members?
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10%
15%
20%
Not at this time
Did another business/organization refer you to The Chamber? If so, please tell us who!
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Would you like to subscribe to our e-news letter?
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Number of Employees:
Full Time Employees
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Enter the # of employees
Part Time Employees
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Managers
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Enter the # of managers
Owners
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Enter the # of owners
Which social media sites is your business on?
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Please include handles/links
What would you like your online business profile to say?
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What can The Chamber do to help grow your business? What are your expectations?
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