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General Information

Your Name		(required)
Company or Organization		(required)
Street Address		(required)
City		(required)
State		(required)
Zip		(required)
Phone (with area code)		(required)
Email Address		(valid email required)
Website
Type of business (restaurant, software, etc.)		(required)

Green Certification

Does your business have a certification not currently recognized by the Green Chamber? (Recognized certifications: Green America, B Corp)
Yes No
If so, please name the program:

Chamber Membership How did you find out about us?

Referral from current Member	Attended Green Chamber of Commerce event
Internet search	other
If you were referred by another member, please put the name/organization here:
If you chose "Other" please provide details here:
Which committee of the Green Chamber of Commerce can you join?
Membership	Political Activism
Fundraising
Media	Events

About your Green Business

What are your green business goals for the coming year?

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