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Organization Information (to be displayed online)
Main Contact
Additional Contacts
Contact 1
Contact 2
Contact 3
Contact 4
Contact 5
Contact 6
Contact 7
Contact 8
Contact 9
Contact 10
Billing Address (if different)
Mailing Address (if different)
Additional Information
Membership Investment
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  • Secondary categories are subject to additional fees ($99 ea)
 
 
   
 

The contents of this box are for testing purposes. This box will be removed when the form goes live.


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information

Name on Card
Security Code
Valid Through
Address
City
State
Zip
Phone
Credit Card Email Address

By entering into a membership with the Santa Rosa Chamber of Commerce (“the Chamber”), you authorize the Chamber to take, use and publish photographs of you for any and all purposes related to the Chamber. You further authorize and acknowledge that the use of the photographs does not require your written or oral consent and may be used with or without the use of your name and/or company for lawful purposes including but not limited to social media (i.e. Facebook, Twitter), e-mail communications, advertising (whether electronic or in print format), marketing or any other purpose that the Chamber sees fit. You further authorize the disclosure and use of your name and your company/affiliation for any and all purposes related to the Chamber and acknowledge that the Chamber may do so without written or oral consent prior to its use.

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