2018 Chamber Membership Form
Use this form to apply for, or renew, membership to the Charlestown, IN Chamber of Commerce. Dues are $125.00 per year. You may pay via credit card using the link in the last question (a $4.00 service fee applies). Your dues cover two members; additional representative memberships are available for $25.
Email address *
Company Name *
Your answer
Primary Product or Service *
Your answer
Main Business Telephone Number *
Your answer
Website Address
Your answer
Business Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Primary Member Name *
Your answer
Primary Member Phone *
Your answer
Primary Member Email Address *
Your answer
Second Member Name *
Your answer
Second Member Phone *
Your answer
Second Member Email Address *
Your answer
Do you want to pay your dues now? *
A copy of your responses will be emailed to the address you provided.
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