Member Application

Kosciusko Chamber of Commerce

We are excited that you will be partnering with your Kosciusko Chamber of Commerce. We look forward to working together with you to promote your organization and continuing to build a strong community. Upon the completion of this application, your organization will be charged a one time application fee of $25 in addition to your annual membership dues.

Step 1:

Member Info
Please add your company name.
Please add your company phone number.
Please add your company website.
Please add a valid email.
Physical Address
Please add your address.
Please add your country.
Please add your City.
Please add your State.
Please add your Postal Code.
Mailing Address
Please add your address.
Please add your country.
Please add your City.
Please add your State.
Please add your Postal Code.

Step 2:

Additional Info
Please add your company description.
Please add your number of full-time employees.
Please add your number of part-time employees.

Step 3:

Primary Contact
Please add your first name.
Please add your last name.
Please add your phone number.
Please add a valid email.

Contact Preference

Step 4:

Billing Contact
Please add your first name.
Please add your last name.
Please add your phone number.
Please add a valid email.

Contact Preference

Step 5:

Additional Fees:
Payment Option
Please complete the Captcha