Application | Timmins Chamber of Commerce

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Application

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Organization Information (to be displayed online)

Organization Name

Address 1

Address 2

City

Province

Postal Code

Phone

Fax

Website

Business Profile

Business Start Date (month/day/year)

Please list your social media sites:

YouTube
Facebook
Twitter
LinkedIn
Pinterest
Instagram
Snapchat
TripAdvisor

Main Contact

First Name

Last Name

Title

Phone

Additional Contacts

By providing your email addresses, you agree to receive the Chamber's weekly e-newsletter and other event correspondence.

Contact 1

First Name

Last Name

Title

Email Address

Contact 2

First Name

Last Name

Title

Email Address

Contact 3

First Name

Last Name

Title

Email Address

Contact 4

First Name

Last Name

Title

Email Address

Contact 5

First Name

Last Name

Title

Email Address

Contact 6

First Name

Last Name

Title

Email Address

Contact 7

First Name

Last Name

Title

Email Address

Contact 8

First Name

Last Name

Title

Email Address

Contact 9

First Name

Last Name

Title

Email Address

Contact 10

First Name

Last Name

Title

Email Address

Billing/Mailing Address (if different)

Address 1

Address 2

City

Province

Postal Code

Additional Information

What is your reason for joining?

How did you hear about us?

Website
Facebook/Twitter
Postcard from Chamber
Member Referral
Other

Are you interested in offering a Member to Member discount? YesNoI would like more information

Membership Investment

Primary Directory Category

Number of Full Time Employees

Number of Part Time Employees

Annual Membership Investment

One-Time Application Fee

Tax

Total

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Additional Items

Additional Categories Cost

Number of Rooms

Number of Seats

Number of Associates

Number of Locations

Millions in Assets

Enhanced Membership ($50)

Additional Directory Categories

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Secondary categories may be subject to additional fees

Membership Type

Full-Time Employees

Part-Time Employees

Hotel/Motel Rooms

Restaurant Seats

Additional Associates

Additional Associates Cost

Additional Locations

Additional Locations Cost

Assets

Assets Cost

Additional Categories

Number Of Additional Categories

Additional Categories Cost

Additional Item 1 Cost

Additional Item 2 Cost

Additional Item 3 Cost

Additional Item 4 Cost

Additional Item 5 Cost

Additional Item 6 Cost

Additional Item 7 Cost

Additional Item 8 Cost

Additional Item 9 Cost

Additional Item 10 Cost

Annual Dues (charged to card)

Revenue Item

Tax (charged to card)

Fee (charged to card)

Temp Value For DropDown 1

MembershipType

Additional Item 2

Additional Item 3

Additional Item 4

Additional Item 5

Additional Item 6

Additional Item 7

Additional Item 8

Additional Item 9

Additional Item 10

Payment Type

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

Credit Card Type MastercardVisa

Credit Card Number

Name on Card
Security Code
Valid Through
Address
City
Province
Postal Code
Phone
Credit Card Email Address

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Timmins Chamber
76 McIntyre Rd
Schumacher, ON P0N 1G0

Membership

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About the Chamber

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