Membership Interest Form
Please fill out the following information.  (*) indicates a required field.

Company Name*
Contact First Name*
Contact Last Name*
Title
Physical Address*
City*   State*   Zip*
Mailing Address (If Different)
City   State   Zip
Telephone*   Ext.
Fax   Toll-Free
Email  
Web Address
Year Established  
Type of Business*
Short Description of Business
How did you hear about the Chamber?
Preferred Method of Contact


 

 

 

 


© Copyright 2008 Elizabeth City Area Chamber of Commerce.  All rights reserved.
502 E. Ehringhaus St., Elizabeth City, NC  27909
252-335-4365  Fax: 252-335-5732