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Company InformationPlease fill in all appropriate areas

Business Name *

Physical Address *

City *

State/Province *

Postal Code *

Mailing Address *

Business Phone *

Cell Phone *

Email Address *

Website *

Logo

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Member Privacy Option *YesNoDoes the Chamber of Commerce have your permission to publish your information on our website, business directory or any other medium and given out to the public?

Contact Information

Owner/Manager *

Contact Name (if other than owner/manager)

Title

Phone *

Chamber Emails *YesNoNot all Chamber of Commerce information is distributed by email. Would you like to receive Chamber emails?

Business Description

History *When you started, why are you doing business in Kindersley, is it a family owned business, etc.

Community Support *Events and sponsorship

Service and Products provided, Hours of Operation *

Certifications, Designations, Partnerships, Other Association Memberships *

Areas of Interest: *Board of DirectorsGoose FestivalTrade ShowCasual HelperOtherWould you prefer to meet with a Chamber of Commerce representative to learn more about what the Chamber has to offer?Please tell us how you would be able to help out as a Chamber of Commerce member; Check all that apply.

How did you hear about the Chamber?AdvertisementPersonal ReferralOtherPlease tell us how you heard about the Chamber – check all that apply.

Membership and ProgramsPlease indicate which membership level applies to you and your company.

Please select a membership. Explanation of the Membership Packages can be found on our Memberships page.

Select Membership *Corporate Gold Membership - $1,000 + GSTCorporate Silver Membership - $500 + GSTGeneral Bronze Membership - 20+ Employees - $350 + GSTGeneral Bronze Membership - 6 – 19 Employees - $300 + GSTGeneral Bronze Membership - 3 – 5 Employees - $250 + GSTGeneral Bronze Membership - 1 – 2 Employees - $225 + GSTNon-Profit/Charitable/Community Group - $125 + GSTHome-Based Business - $75 + GST

All memberships expire December 31st. Membership fees only will be pro-rated quarterly. Please contact the Chamber office for more information. The Chamber of Commerce offers various programs for your business to participate in; please refer to your membership package for detailed information. If you do not have a copy, please contact the Chamber office.

Code of Conduct and Commitment

"As a member of the Kindersley & District Chamber of Commerce, I agree to conduct all business and professional activities in a reputable manner to reflect honorably upon the Kindersley Chamber of Commerce and the District of Kindersley business community."

Name *

Date *

Payment

Your application will be processed at the time payment is received. Please select your method of payment. An invoice will be sent to you to collect payment. Membership dues are non-refundable. Your Chamber membership is 100% tax deductible as an operation expense. Membership renewals are due by January 31st of the current membership year.

Total (GST not included)

$CAD

Payment Method *

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Membership Application Form