New Membership

Business Name*

Business Address*

Address Line 1

Address Line 2

*

City

*

State

*

Zip

Business Phone*

Website URL/Facebook Page (For Promotional Purposes)

Description or Type of Business Activity*

Your First name*

Last name*

Your Phone/Cell if different than business number

Please select the Month you are submitting your membership application -- Dues are prorated for the first year's membership. *

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Hours:

Tues-Saturday

10 am to 4 pm

PO Box 896

Long Beach, WA 98631

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