Membership Form

Fill in the form below and then click the submit button at the bottom of the page. Fields marked with an must be filled in.

Contact Person:
Title:
Company Name:
Address:
Bill To Address: (if different)
City:
State:
Zip:
E-Mail:
Web Site: (if available)
Phone Number:
Toll Free Phone:
Fax Number:
Description of Business:
Membership Dues
Membership Type
Individual representing a business, industry or profession located in or doing business in the Middlefield Area. This person should be actively engaged in the day to day business activity of the member business.
Individual who does not meet the above criteria but subscribes to the goals of the Middlefield Chamber of Commerce and desires to support our work through membership.
Individual who has distinguished himself/herself by meritorious service to further the cause of this organization.
 Change Image
Enter the Code
from Above:
Send Membership