Wahpeton Breckenridge Area Chamber of Commerce Membership Application

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Membership Application

Your Name or Business Name:

Mailing Address:

Street Address (if different):

City, State, Zip:

Phone:

Fax:

E-mail:

Website:

Owner/President/Voting Representative:

Contact Person;

Type of Business:

Full Time Employees:

Part Time Employees:

Established:

Interested in having a Ambassador Visitation at my business:
Yes
No

Interested in:
Volunteering
Serving on a Committee
Working on a Special Event

Describe your business. Information will be used for advertising purposes:

You may either print out the Application Form and mail it along with your payment for the amount due or submit the Form online and then mail your payment to: Wahpeton Breckenridge Area Chamber of Commerce, 118 North 6th Street, Wahpeton, ND 58075.