This is who you are representing to represent at Chamber: representing a Business?representing a Not-for-Profit Organization?representing yourself only?
First Name:
Last Name:
Mailing Address:
Email Address:
Home Phone:
Cell Phone:
Business or Not for Profit Organization Name:
Business or not for Profit Mailing Address:
Business or Service Phone Number:
Business or Service Email:
Business or Service Website:
List Business or Service Information on Rapid City Website:YesNo
Total number of employees (working more than 24 hours a week) 1234567891011121314151617181920212223242526272829303132333435363738394041424344454647484950
Agreed to be mentioned on social media as new member of the Rapid City and District Chambers of CommerceYesNo
** Receive annual renewal letter and all correspondence through: Above Email, orMailing Address
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