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*

Community Partner
Power Partner
Premier Partner
Visionary Partner

Online & Print Directory Presence (Community Partner 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 (All Levels)
Twitter URL (Power Partner Level and Up)
Facebook URL (Power Partner Level and Up)
LinkedIn URL (Power Partner Level and Up)
One Business Category (Community Partner level and up) (e.g. Hospitality, Construction, etc.)
Searchable Online Keywords: Community=2, Power=3, Premier & Visionary=4
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

Payment

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