Member

Member Application

Welcome to the Brick Township Chamber of Commerce! The Brick Township Chamber of Commerce is a non-profit business association made up of local businesses within Brick, as well as businesses looking to conduct business within our area. Our mission is to enhance and advance business, commerce, and the community. We strive to ensure that the Township of Brick is recognized as a great place to live, work and visit. Together we can build business Brick "Buy" Brick!

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Contact

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Step 2:

Additional Info

Business Description (200 char max) *

Please add your company description.

Business Keywords * (enter a space between words)

Please add your business keywords.

Directory Category *

Please select a directory category.

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

Referred by

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Facebook

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Create Account

Password *

Please add your login password.

Step 5:

Comments/Questions

Payment Option

Bill Me

Please complete the Captcha

Back Next Submit Application Print Application