Join Us

Join the Greater Norwich Area Chamber of Commerce by completing and submitting the following form. A representative will contact you shortly to confirm receipt and to welcome you to our organization. You will be invited to attend a New Member Orientation meeting which is an informal gathering of seasoned Chamber members and staff who will help you get the most from your membership investment. If you would like information, but are not positive about joining, please email to membership@norwichchamber.com. Please feel free to call us at 860-887-1647 with any and all questions or concerns.
 

Date:
Primary Contact's Name:
Title:
E-mail:
Phone and Ext.:
Fax:
Business Web Address:
Would you like a free link from our site to your site?	Yes No
Business Name: (This is the proper legal name of the company joining the Chamber):
DBA�s: (If your business operates using another company name or uses an acronym or other familiar name then list them here)
Referral by (optional):
Physical Address - Where is your business physically located?
Address1:
City:
State:
Zip:
Address2:
City:
State:
Zip:
Billing & Mailing Address - Please complete if different than your physical address.
Address:
City;
State:
Zip:
Billing Address - If you prefer to have bills mailed to another address please complete this section.
Address:
City:
State:
Zip:
Billing Contact Name: (if different than primary contact)
Billing Phone:
Additional Branches/Contacts If your business would like to list branch information with the Chamber in our referral lists, directories or to receive mailing to additional business addresses. If you would like to have additional people receive Chamber mailings please fill out this portion with their name, address, phone, fax and e-mail address.
General Information:
Principal Corporate Officer : (President, GM, CEO etc.)
Title:
Additional Branch 1:
Additional Branch 2:
Additional Branch 3:
Additional Branch 4:
Year Business Established:
Number of Employees:	Full Time: Part Time/Seasonal:
Provide a brief description of your primary products or services for our website (maximum 100 words):
Payment Method:	Visa MasterCard Discover American Express
Credit Card Number:
Expiration Date:

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