Member Application:

* Company Name:  
* Phone:  
* Website:
* Email:
 
* Newsletter Insert:
 
* Physical Address:  
* City/State/ZIP:  
Country:
 
* Mailing Address: Same as physical address
* City/State/ZIP:
Country:
 
* Directory Category:
* Employees: Full-time:      Part-time: 
Comments/Questions:
 
Social Networking: LinkedIn:
Facebook:
 
 

Primary Contact Information:

* Name (First / Last):  /   
* Title:  
* Phone:  
Cell Phone:
* Fax:
* Email:  
Contact Preference: Email  Phone
 
Social Networking: LinkedIn:
Facebook:
 
* Address: Same as Member Address
* City/State/ZIP:
Country:
 
 

Billing Contact Information:

Same as Primary Contact
* Name (First / Last):  /   
* Title:  
* Phone:  
Cell Phone:
* Fax:
* Email:  
Contact Preference: Email  Phone
 
Social Networking: LinkedIn:
Facebook:
 
* Address: Same as Member Address
* City/State/ZIP:
Country:
 
 
Membership Package:
Level 1: $300.00
Your organization has less than 10 employees.
Level II: $415.00
Your organization has 10 or more employees.
Additional Opportunities:
We will contact you with additional information.
One-Time New Member Application Processing Fee: $25.00
A one-time application processing fee is added on for new member applications.
Payment Option:
Bill me
Charge my credit or debit card
 
 
Submit Application:
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TWIN CITIES NORTH CHAMBER OF COMMERCE - ROSEVILLE MEDICAL AND DENTAL CENTER - 1835 COUNTY ROAD C, SUITE 22 - ROSEVILLE, MN 55113
Phone: 763-571-9781 - Fax: 763-572-7950 - info@twincitiesnorth.org     -  Site designed and hosted by Risdall Advertising