New Member | Gallup Chamber of Commerce and Tourism Information

The Gallup McKinley County Chamber of Commerce appreciates you taking the time to consider becoming a member of our organization. Please be as thorough as possible with the information you provide in the following application, as this information is important in helping us to provide the best service to our members.

Business Information

Company Name: *

Phone: *

Website:

Business Category:

Employees:

Full-time Part-time

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State / Province:

ZIP / Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

Zip / Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

ZIP / Postal Code:

Country:

Membership Options

Membership Package: *

Business Membership - 1-5 Employees: $225.00
General Business Membership with 1-5 Employees Business Membership - 6-15 Employees: $275.00
General Business Membership with 6-15 Employees Business Membership - 16-45 Employees: $525.00
General Business Membership with 16-45 Employees Business Membership - 46-100 Employees: $775.00
General Business Membership with 46-100 Employees Business Membership - 101-Plus Employees: $1,475.00
General Business Membership with 101-Plus Employees Educational Institutions Membership: $500.00
Membership for Educational Institutions (excluding day care centers) Governmental Entities Membership: $500.00
Membership for Governmental Entities

Additional Fees:

Application Fee : $25.00
One Time Set Up Fee for New Member Applications

Payment Option:

Bill me

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 6 plus 4?: *

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