Application

Welcome and thank you for deciding to join the Coral Gables Chamber of Commerce. We trust that your experience with our Chamber will be rewarding and that your business will grow by leaps and bounds. Remember that involvement is key to your success! We look forward to seeing you soon.

* = required

Company Name:*

Address:*

City:*

State:*

Zip:*

Phone:*

Fax:*

Website:*

Email:*

Directory Classification:
(Yellow Pages Listing)

Recommended By:

Number of Employees:

Year Established:

Emergency Contact:

Emergency Phone Number:

Membership Investment

Investment Categories:

Trustee Member - $2,950 - Up to five representatives - Special monthly luncheons and receptions	Corporate Member - $1150 - Up to three representatives
Business Member - $575 - One representative	International Member - $450 - One representative
Non-Profit Organization - $350 - One representative	Retail Membership - $365 + $250 Trade - One representative
Restaurant Membership - $250 + $250 Trade - One representative - $250 trade - 5 $50 gift certificates	Business Associate - $350 - Additional representative added to any level of membership

Membership Type: *

Required

Chamber Representatives

First Name	Required Please enter a valid number Please enter a valid date
Last Name	Required Please enter a valid number Please enter a valid date
Title	Required Please enter a valid number Please enter a valid date
Email	Required Please enter a valid number Please enter a valid date

Number of Representatives:

Annual Membership Investment

One-Time Application Fee

Total: $

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Primary Directory Category *

Additional Directory Categories

**Hold CTRL on your keyboard to select multiple categories**

Number of Full Time Employees:

Number of Part Time Employees:

Number of Rooms (Accommodations):

Number of Seats (Restaurants):

Number of Locations ($35/add. location):

Enhanced Membership ($50):

Additional Categories Cost

Tax

Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost

Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)

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Payment Type *

NOTE: If selecting to pay by Company/Corporate Check please contact the Chamber at 305-446-1657. Thank you.

Credit Card Information

Credit Card Type *

Mastercard

Visa

Discover

Amex

Credit Card Number *

Name On Card	Required
Security Code	Required
Valid Through
	Use Address Above
Credit Card Address 1	Required
Credit Card City	Required
Credit Card State
Credit Card Zip	Required
Credit Card Email Address