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Join The Fort Nelson Chamber of Commerce - Membership Listing Application

Please fill out the following application form.

Fields with asterisks (*) are required.
Fort Nelson Business
* General Email (Username):
* Password:
* Company:
Legal Company Name:
* Business Address:
* City:
* Province:
Other Province
* Postal Code:
* Country:
Other Country:
Has Different Mailing Address:
Mailing Address:
City:
Province:
Other Province:
Postal Code:
Country:
Other Country:
* Business Phone:
Secondary Phone:
Toll-Free:
Fax:
Display Website1 Address in Directory
Website1:
Website2:
Business Start Date:
No Of FullTime Employees:
No Of PartTime Employees:
No Of Seasonal Employees:
No Of Other Employees:
Information Broadcast Method:
Home Based Business:
* Business Types:
Category:
Sub Category:
Membership Type Rate GST TotalProrated Fee GST Total
Individual/Private 50.00 0.00 50.00 54.17 2.71 56.88
Non-Profit Association 70.00 0.00 70.00 75.83 3.79 79.62
Seniors/Students 30.00 0.00 30.00 32.50 1.63 34.13
Business with Sole Proprietorship 70.00 0.00 70.00 75.83 3.79 79.62
Home Based Business 70.00 0.00 70.00 75.83 3.79 79.62
1 - 5 Employees 125.00 0.00 125.00 135.42 6.77 142.19
6-25 Employees 200.00 0.00 200.00 216.67 10.83 227.50
26 - 50 Employees 250.00 0.00 250.00 270.83 13.54 284.37
51-99 Employees 350.00 0.00 350.00 379.17 18.96 398.13
Over 100 Employees 500.00 0.00 500.00 541.67 27.08 568.75
Membership Fee Charged:
$0.00
FeeType Fee
Name Tags Fee 50.00
Test Fee Type 25.50
Other Fee Charged:
$0.00
Total Fee Charged:
$0.00
Company Logo:
Member To Member Discount:
Member To Member Discount Desc:
Member To Public Discount:
Member To Public Discount Desc:
Brief Business Desc:
Detail Business Desc:
Reason For Joining:
Referred By:
Contact Information
 
Payment Information
Payment Method:
Card Number:
Name On Card:
Expiry Date:


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