Member - Douglas-Coffee County | Members

Thank you for you interest in partnering with the Chamber of Commerce! Please fill out the below application completely and accurately. We will use this information to build your directory web page and refer clients to you! If you have any questions about the application, give us a call at 912.384.1873!

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Twitter

Instagram

Step 2:

Additional Info

Business Description (200 char max)

Business Keywords (enter a space between words)

Directory Category

Full-time Employees

Part-time Employees

Hours of Operation

Partnership Goal 1

Partnership Goal 2

Partnership Goal 3

Please select a payment option

Please select a payment method

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Email *

Please add a valid email.

Contact Preference

Phone

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Contact Preference

Phone

Create Account

Password

Step 5:

Payment Option

Charge my credit or debit card

Please complete the Captcha

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Douglas-Coffee County

members

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Create Account

Step 4:

Billing Contact

Create Account

Step 5:

Payment Option