Become a Member

Wallaceburg & District Chamber of Commerce members are entitled to a number of great member discounts and perks.

For more information on Chamber membership, please contact the Chamber’s administrative assistant, Tina Fraleigh.

Member Application Form

If you are interested in becoming a chamber member, please fill out the following form. Clicking the “Submit Application” button will send your information to our office. A representative will be in touch with you within two business days to confirm your application.

 


 

    *Legal Name of Firm or Individual (required)
    (Ex. numbered company, include "Inc." or "Ltd." if applicable):
     
    Marketing Name of Firm
    (As you wish for it to appear in the directory):
     
    Which Membership Level would you like to enrol in? View Membership Level Benefits here.
    GoldSilverBronze
     
    Physical Address (required)
    (This address is used for publication):

    City:

    Postal Code:
     
    *Mailing Address (required)
    (This address is used for publication):

    City:

    Postal Code:
     
    *Billing Address (required)
    (This address is used for publication):

    City:

    Postal Code:
     

    Phone (required):

    Toll Free:

    Fax:
     

    Company Email:

    Company Website:
     

    *Year Firm Established:
    *Number of Employees
    Part-time:
    Number of Employees
    Full-time:
     
    Business Category (required)
    (One category listing is standard with membership):
     
    Representative:
    Main Contact:

    First and Last Name:

    Title:

    *Email:
     
    How would you like to receive your Chamber correspondence (please check one):
     
    Business Description:
    Please provide a brief company description (30 words or less) to be used for Chamber publications when needed.
     
    Note: All above information marked * will not be produced for Wallaceburg & District Chamber of Commerce publications.
    We hereby acknowledge we are consenting to the publication of the above provided information, including Business Name, Mailing Address, Fax and Telephone Number, Representative, Business Email and Website, in the Members' Directory, the posting of this information on the Chamber's website and any other similar listing that may be published and distributed in order to assist members and non-members to contact my business. Should you have any concerns regarding your privacy, please contact Administrative Assitance, Tina Fraleigh, at 519-627-1443.
    Please review our website privacy policy and terms of use for more information.