Business
Name:

Zip Code:

City:

Street
Address:

Mailing
Address:

Phone #:

Business
Category:

Fax #:

Business / Non-profit / Club Membership

Number of
employees:

Name of
Principal:

Title:

Individual / Associates Membership

Name:

State:

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New Membership

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Step 1

Step 2

OR

Step 3

Email:

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Step 4 (businesses only)

(Example: Automotive, Restaurant, Church, etc)

Business
Description:

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Become a Member of the Helendale Chamber of Commerce
Online Form

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Individuals-$40.00   Those members with no business affiliation, and no advertising needs

Regular Business Member $75.00  

Large Business Member (50+ employees) $100.00        Government Entities $100.00