MEMBERSHIP APPLICATION
Membership Information
New
Renewal
Name
Title
Company/Organization
Year Established
Address
City
State
Zip
Phone
Email
Website
Number of Employees
Type of Business
Please provide a brief bio, including company history and a description of your products/services
MEMBER CATEGORIES
General Membership $250
Executive Membership $500
Community Partner Membership $2,500
Silver $Partner Membership $$10,000
Gold Partner Membership $ $15,000
Platinum Partner Membership $25,000
Mail Check Opition
I will mail in a check addressed to:
Moreno Valley Hispanic Chamber of Commerce
25920 Iris Ave. Suite 13A PMB 342
Moreno Valley, CA 92555
Type Full Name (Electronic Signature):
Date
I authorize this submission and agree that typing my name below serves as my electronic signature.
Submit and Pay
Please contact our Membership Chair, Brenda Romero: 951-665-4952 for more information!
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