Black Chamber of Commerce of Orange County
2323 North Broadway, Suite 302
Santa Ana, CA 92706

Phone: (714) 547-2646 - Fax: (714) 547-2648 - http://www.ocblackchamber.com

Date: / /

MEMBERSHIP APPLICATION

For online payment and application click here.

New Membership ........................................................................................Renewal Membership

Rates of Chamber Membership

(Please check the appropriate box)

Student

$25.00

 

Individual

$250.00

 

Small Business

$250.00

 

Corporate

$2000.00

 
 
 
Credit Card Number
Exp. Date
Name on Card
Check Number:
Total Amount:

Make your check payable ot the Black Chamber of Commerce of Orange County.

Print and mail this form with your payment.

 

The following information will used in the Chamber Membership Directory:

Company Name:

Contact Person: Number of Employees:

Title:

Mailing Address:

Mailing Address:

City / State / Zip:

Type of Business:

Telephone Number: Fax Number:

e-Mail:

 

Thank you for your membership and enrolling in our Chamber for the betterment of the community!