Member Application - Waukee Chamber of Commerce

Member Application

Grow your business by joining the Waukee Area Chamber of Commerce today!  Please complete the membership application below to start taking advantage of all of the benefits and opportunities the Waukee Chamber offers!
* denotes a required field.
General Information
First Name: *
Last Name:  
Title:  
Company:  
Website Address:  
Address 1: *
Address 2:  
City: *
State: *
Zip: *
Phone:  
Fax:  
E-mail: *
Payment Information
Product Quantity Price Subtotal
Product Quantity Price Subtotal
Small Business:  
Quantity: 
Price:   $260.00
Subtotal: 

1-6 Full Time Employees

  
 
Medium Business:  
Quantity: 
Price:   $375.00
Subtotal: 

7-19 Full Time Employees

  
 
Large Business:  
Quantity: 
Price:   $780.00
Subtotal: 

20 or more Full Time Employees

  
 
Small Non Profit:  
Quantity: 
Price:   $195.00
Subtotal: 

1-6 Full Time Employees

  
 
Medium Non Profit:  
Quantity: 
Price:   $282.00
Subtotal: 

7-19 Full Time Employees

  
 
Large Non Profit:  
Quantity: 
Price:   $585.00
Subtotal: 

20 or more Full Time Employees

  
 
Individuals:  
Quantity: 
Price:   $175.00
Subtotal: 

Retired, Not affiliated with a business or organization

  
 
Total Amount Due:  
Billing Information
Payment Type: * Check

Please make checks payable to the Waukee Area Chamber of Commerce. Checks can be mailed or delivered in person to the following address:

208 W. Hickman Road 
Waukee, IA 50263
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