Become A Member

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Please fill out all required fields. An Iowa Quad Cities Chamber of Commerce staff person will review your application and be in touch.

* Required
Company Name: *
Established in:
Physical Address: *
City: *
State: *
Zip: *
Telephone: *
Fax:
Email:
Web Address:
Mailing Address (if different from Physical Address)
City:
State:
Zip:
Billing Address (if different from Physical or Mailing Address)
City:
State:
Zip:
Main Contact (One contact for every $100 in membership dues. Each additional contact is $10.): *
Title: *
Email:
Mailing List:
Yes    No   
Who's Who:
Yes    No   
Second Contact:
Title:
Email:
Mailing List:
Yes    No   
Who's Who:
Yes    No   
Third Contact:
Title:
Email:
Mailing List:
Yes    No   
Who's Who:
Yes    No   
Business Category:
Total Number of Employees:
Full-Time:
Part-Time (Each part-time employee is calculated as 1/2 a full-time employee.):
Dues Investment (A $35 one-time administration fee is charged to each new member business.):
Website & Email Hotlinks (A $20 annual fee will be on final invoice.):
Yes   
Women Owned?
Yes    No   
New Member Profile (Please write a 35-word profile about your business for use in the Iowa Quad Cities chamber publications or Website):
NOTE: Your "New Member Profile" will be read by nearly 2,600 business and professional people. Please do not release information you do not want published. The Iowa Quad Cities chamber reserves the right to refuse any profile. Iowa Quad Cities Chamber reserves the right to edit any "New Member Profile." It is the ultimate responsibility of the member to make sure they submit a profile for inclusion and that it is accurate and free of grammatical and/or spelling errors. Profiles will be printed in the newsletter on a first come, first serve basis. Please return your profile to us. The deadline for each month is the 15th of the preceding month.
Please type the number 94890:
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