The Black Chamber of Greater KC Business Registration Form
The Chamber will be a central resource, voicing the needs and challenges facing black businesses as well as promulgating and sponsoring legislative and public policy issues of significant concern to our businesses.

To receive additional information or to get involved with the Black Chamber of Commerce please complete the form below.

Email address *
Date *
MM
/
DD
/
YYYY
Firm Name *
Your answer
Contact Representative *
Your answer
Position *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone *
Your answer
Fax
Your answer
Website
Your answer
Business Description *
Your answer
Business Entity Structure *
Required
Number of Years in Business *
Your answer
Type of Business *
Required
Annual Gross Income *
Business Certifications *
Membership Investment Schedule
BCCGKC Committee(s) *
Method of Payment *
A copy of your responses will be emailed to the address you provided.
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