"*" indicates required fields Please select membership package Basic Membership $200 Non-Profit/Government $250 Relationship $375 Development $1,000 Premier $2,500 Visit this page to see the features and benefits of each package. For checks, please mail to 5072 Annunciation Circle, Suite 327, Ave Maria, FL 34142 YOUR BUSINESSCompany NameDatePhysical Address (Published in Public Directory)Mailing AddressPhoneFaxWebsite Main Contact(Main contact is listed in Immokalee Eastern Chamber website)TitleEmail Total # of Employees:Full TimePart TimeOnline Directory Category 1Online Directory Category 2Business Description (Will be displayed on website)REASONS FOR JOINING THE CHAMBER Economic Development Updates Business Networking, Marketing & Visibility Business Education and Training Other Are you a real human?*Please show us by solving this equation… 5 + 5 =Select one51015CAPTCHAPAYMENT INFORMATION(# required on file for payment plans. Dues charged by 5th of month.)Billing AddressSelect Payment Method Cash/Check Credit Card Bank EFT Check NumberCredit CardName on CardCC#Exp. DateCC 3-Digit Sec. CodeSignatureBank EFTBank NameRouting NumberBank AddressAccount NumberSignature
