Membership Application

Membership Application

Gold Beach Chamber of Commerce

Business/Organization Name: ______________________________

Contact Person: _________________________ Title:___________________

Type of Business: _______________________________________________

Website: ______________________________ Email:_______________________

Physical Address: _________________________

City _________________State___ Zip______

Mailing Address: _________________________

City __________________State___ Zip_____

Phone Number:__________________________

Anything else you would like us to know about your business: 

___________________________________________________________________

___________________________________________________________________

Please print out and send along with your $25.00 Membership dues to 

Gold Beach Chamber of Commerce

PO Box 489

Gold Beach, OR 97444

Thanks for your support!