Company Information

Company Name*
Referred By (Sponsor)
# of Employees*
Main Phone #*
Fax #
Toll Free #
General Email*
Permission to Email and/or Fax*
Yes
No
Main Contact First Name*
Main Contact Last Name*
Main Contact Title*
Main Contact Email*
Main Contact Phone*

Mailing Address

Address*
City*
State*
Zip*

Physical Address (if different)

Address
City
State
Zip

Billing Address (if different)

Address
City
State
Zip

Membership Investment*

Bronze
Silver
Gold
Platinum
Diamond
Mission

Online & Print Directory Presence (Silver Level and Up)

Would you like your address to appear in our PRINTED directory? (check one)*
No Address
Mailing Address
Physical Address
Billing Address
Not Applicable (Bronze Level Membership)
Would you like your address to appear in our ONLINE directory? (check one)*
No Address
Mailing Address
Physical Address
Billing Address
Not Applicable (Bronze Level Membership)

Additional Contact #1 (for the online directory)

Name
Email
Phone

Additional Contact #2 (for the online directory)

Name
Email
Phone

Links

Website URL (Silver Level and Up)
Twitter URL (Gold Level and Up)
Facebook URL (Gold Level and Up)
LinkedIn URL (Gold Level and Up)
One Business Category (Silver Level and Up) (e.g. Hospitality, Construction, etc.)
Searchable Online Keywords/Categories (Silver=3, Gold=4, Platinum-Mission=5)
I'm unsure about my business category and/or keywords, please contact me.

Connecting with the Beaverton Chamber

I give the Beaverton Area Chamber of Commerce permission to... (check all that apply) Add me to the email list to receive the eNews.
Add me to the Beaverton Chamber LinkedIn Group
Add me to the Beaverton Chamber Facebook Group

Your Areas of Interest (check all that apply)

Committee Involvement Ambassador
Annual Auction
Annual Golf Event
BizEd
Business Advocacy
Business Conference
#Driven
Membership Task Force
PRO*Development/Business Matters!
Event Sponsorship/Participation Annual Auction
Annual Golf Event
BizEd
Business Luncheon
#Driven
PRO*Development/Business Matters!
Other Advertising
Booth at our Business Conference
Leadership Beaverton
Mentor Program
Ribbon Cutting (Gold Level and Up)
Speaking/Training
Volunteering

Payment

Payment Method (select one)
Credit Card
Check
Verify
Once you submit this application you will be redirected to a payment option page.