Membership Application

* indicates a required field.

Business Information

Business Name *

Physical Address *

City *

State *

Zipcode *

Mailing Address

City

State

Zipcode

Listing Category and Type of Business

When calculating employee count, be sure to include business owners/proprietors in that count.

Number of Employees: Number of Beds: * Number of Millions in Assets/Deposits: *

Full Time Employees: *

Part Time Employees: *

Annual Membership Investment: $

(A $50.00 Processing Fee will be added)

Business Description

Hours of Operation

Holidays Closed

Business Contact Information

Telephone *

Fax

Email Address *

Website

Primary Contact

First Name *

Last Name *

Title

Address

City

State

Zipcode

Secondary Contact

Name

Address

City

State

Zipcode

Other Information

Birthdate

Redondo Beach voter?

Yes

# of employees who are
Redondo Beach voters

Chamber Officer?

Yes

Please indicate by checking the appropriate areas that are of primary interest to you, or those in which you would like to participate.

Business Services

Yes

Communication

Yes

Education Partnership

Yes

Governmental Affairs

Yes

Membership Services

Yes

Special Offers

Yes

Credit Card Information

Credit Card Type *

Mastercard

Visa

Discover

Amex

Credit Card Number: *

Name On Card	Required
Security Code	Required
Valid Through
	Use Address Above
Credit Card Address 1	Required
Credit Card City	Required
Credit Card State
Credit Card Zip	Required
Credit Card Phone Number	Required
Credit Card Country
Credit Card Email Address

Please click submit only one time. The transaction may take several seconds.

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