Membership Application- Benicia Chamber of Commerce & Visitor Center

Membership Application

Joining the Benicia Chamber of Commerce has never been easier! Just fill in the form fields below to get started.

Please type your information accurately in upper/lower case, not all capitals. Errors may cause delays in processing your membership application.

* indicates a required field
Part One - General Information About Your Business
* Business Name
* Address Line 1
Address Line 2
* City
* State	* Zip Code
Tel	Fax
* Tel
Fax
Website URL

* First Name

Part Two - Size and Type of Business
No of Employees in Entire Company
No of Employees in Benicia
Select the Business Category that Best Describes Your Business
Standard Industrial Classification (SIC Code)
Company Description In 25 words or less, please provide a description of your company, products and/or services. This information will accompany your listing on the online membership directory. The Chamber reserves the right to edit for clarity, brevity and content.

Part Three - Representative Information Your Business' Primary Representative to the Chamber of Commerce

* Last Name
Title
* Tel
Fax
* Email
Part Four - Membership Investment Payment Options
You may pay your membership investment by check or by credit card. We accept Visa and MasterCard. If you choose to pay by check, an invoice will be sent to the Company address entered above.
Method of Payment Visa Mastercard Check
Cardholder Name
Card Number
Card Expiration