FCHCC - First Coast Hispanic Chamber of Commerce

Membership Application

Business Information:

Applicant First Name:*

Applicant Last Name:*

Company Name:

Applicant's Title:

No. of Employees:

Type of product / service:

Is this a certified diverse-owned business?Yes No

Organization that provided certification?

Address:*

City:*

State:*

Zip:*

Business Phone: (xxx-xxx-xxxx) Ext.

Business Fax:

E-mail for Contact Person:*

Alternate E-mail:

Website URL:

Volunteer for FCHCC Committees

Would you like to be active and involved in some of the projects on which we are currently working? Please choose a committee in which you would like to serve:

Agreement

Membership Levels:

Major Corporation (100 employees and more) - $1,000¹
Mid-size Business (51 to 99 employees) - $500 ²
Small Business (1 to 50 employees) - $200³
Individual/Non-Profit Organization - $70⁴
Student - Free

Credit Card/PayPal processing fee: ¹$29.30, ²$14, ³$6.10, ⁴$3.00

Payment Method (Students excluded):*

Credit Card & Paypal (a processing fee will be added)
Check

* required data

If paying by check, please submit payment to:
FCHCC
PO Box 57972
Jacksonville, FL 32241

I agree that upon acceptance to the Association, I will abide by its by-laws and any amendments adopted during my membership and will promote its Mission Statement.

FCHCC Membership Committee

It is the responsibility of the Membership Committee, to assist in the education, growth and perpetuation of the membership of FCHCC. They are charged with the duty to review and verify applications made to our association. It is the duty of the Membership Committee to make recommendations on applications to the sitting Board of Directors of the association, as to the factual worthiness of the application.

It is not the duty of the membership Committee to accept or reject applications. It is however, their duty to notify the Board in the event that there is no opening within the Classification requested for the application.

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