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Encrypted ConnectionSecure Member Application

Understanding Your Membership:
  • Investment covers one business location
  • Membership is continuous unless cancelled in writing
  • For federal tax purposes, a portion of your investment is deductible as an ordinary and necessary business expense and is not a charitable contribution
  • The non-deductible portion of your investment is 18%
  • Your Small Business Membership Fund donation in 100% deductible and will enable small or non-profit business to join and participate

Company Name:

Street Address:

City:

State:

ZIP Code:

Phone Number:

Fax Number:

E-Mail:
Enter your E-Mail address to receive application confirmation.

Internet Website:
We will provide a link to your website from Member Directory.


Primary Officer Name:

Primary Officer Title:

Contact Person's Name:

Contact Person's Title:


Chamber Affiliation:
Bridgeport Stratford Trumbull Other

Investment Amount Rate Schedule:
(choose one schedule)

Schedule 1 - General Membership

1 Employee/Sole Proprietor $240
2-25 Employees $315
26-50 Employees $390
51-75 Employees $490
For over 75 employees, please call BRBC
at (203) 335-3800 for your investment rate.
Schedule 2 - Professional Membership

Accountants, Attorneys, Insurance Agents, Medical Personnel, Real Estate Brokers, Stock Brokers.

Base Rate for Two Professionals $315
Additional professional Employees ($50 each)
No charge for non-professional employees.
Schedule 3 - Non-profit Membership

0-25 Employees $240
26-50 Employees $315
For over 50 employees, please call BRBC
at (203) 335-3800 for your investment rate.
Schedule 4 - Development Membership

Construction, Architects.

Minimum $500

Select Business Category:

Select Additional Business Category:

Number of Employees at this location:
Full Time:   Part Time:

List Names of Employees and Their Titles:

Year Established:

Sales Volume:
$

Applicant Name:

Referral/Sponsor:

Payment Options:
Visa Master Card AMEX Check Cash
Credit Card Number:

Credit Card Holder:


Expiration Date:

Investment Rate: $
Additional Professionals:
Under Schedule 2		 $
Donation:
Small Business Membership Fund		 $
Total:
Including $30 application fee		 $