Location

Company Name*

Please list your company name as you would like it to appear on the website.

Primary Contact*

First Last

Primary Contact Title*

Primary Contact Phone Number*

Primary Contact Email*

Company email

Email you would like to have on your directory listing on the Chamber website.

Company Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address is the same as Company Address*

Mailing Address

Street Address Address Line 2 City State ZIP Code

Business Phone*

Website

Facebook Page

Instagram Profile

Marketing Contact

First Last

Email for employee responsible for your company's marketing

We will work with your marketing staff to make sure we have the best materials to promote your company.

Billing Contact

First Last

Billing Email

Invoices are typically emailed. Please list the email we should use to send the invoice.

Short Description of Business for Chamber Website*

Detailed Description of the Business

Business Category for Directory Listing*

How Many Full Time Employees*

How Many Part Time Employees*

Payment Information*

What do you hope to get out of your South KC Chamber membership?*

How Did You Hear About The South KC Chamber?*

Referred By

Notes

Please use this area to share any additional details or list any questions you have.

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