Membership Information - Champaign County Chamber of Commerce

Please submit your updated Contact Information with your membership renewal. With new systems soon to be in place, we are asking that ALL members complete this form. Thank you!

Membership Information

* Indicates required field

Company Name (as displayed) *

Name *

First

Last

Business Address *

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City

State

Zip Code

Country

Mailing Address (if different) *

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Line 2

City

State

Zip Code

Country

Primary Phone Number *

Alternate Phone Number *

Email *

Billing Contact (If applicable) *

Billing Address (If different) *

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Line 2

City

State

Zip Code

Country

Please contact us with any additional questions by email at [email protected] or by phone at (937) 653-5764. We look forward to hearing from you soon!

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