Membership Registration

Membership Registration Black River Falls Chamber

Full name of business/ individual
Owner and/or manager’s name
Contact person
Location address
Street Address City State ZIP Code
Mailing address
If different than location address.

Street Address City State ZIP Code
Phone Number
Cell Phone Number
Toll Free Number
Email Address
Website
Facebook
Full-time Employees
Part-time Employees
* If lodging/housing facility, Number of lodging/rental units
Description of your business/organization for the Business Directory
Upload logo and any additional photos for your listing on the website.
Drop files here or
Would you like to receive our weekly & monthly newsletters via email?
- Yes
- No
Would you like to participate in the Chamber Bucks Program
- Yes
- No
Are you interested in being on the Chamber board or any of these committees?
- Ambassador Committee
- Annual Dinner Committee
- Board of Directors
- Karner Blue Race Committee
- Oktoberfest Committee
Membership Division*
Membership Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Please call our office with any questions.

Amusement and Entertainment (Cinemas, Arcades, DJ Service, Recreation)
Automotive (new & used)
Home Based Business
Media (Print, Radio, TV, Publishers)
Restaurants (Fast Food, Cafes, Etc)
Retailers (Clothing, Department Stores, Gas/Convenience Stores, Grocers, Gift Shops)
Services (Audio/Visual Supplier, Automotive Repair, Barber/Beauty Salons/Tanning, Chiropractors, Cleaners, Continuing Education Organizations, Day Cares, Electricians, Employment Agencies, Funeral Homes, Insurance, Investment Brokers, Laundry, Massage Therapy, Pet Boarding, Pharmacy, Photography, Plumbers, Real Estate, Security, Surveyors, Taxidermy, Veterinarians, Web Design)
Taverns
Transportation
Wholesalers

Financial Institutions (Banks, Credit Unions, Mortgage Companies, Savings & Loans)
Health Care Institutions (Clinics, Dental Clinics, Eye Care Clinics, Hospitals, Nursing Homes)
Prison/Correctional Institutions
School Districts
Senior Care Facilities

Lodging (Apartments, Bed & Breakfasts, Cabins, Campgrounds, Hotels, Mobile Home Parks, Motels, Resorts)
- 4A: 1-9 Rooms, Cabins or Campsites - $239
- 4B: 10-59 Rooms, Cabins or Campsites - $419
- 4C: 60-99 Rooms, Cabins or Campsites - $525
- 4D: 100 or More Rooms, Cabins, or Campsites - $631

Industry (Construction Companies, Factories, Government Entities, Trucking Companies, Utilities, Etc)

Non Profit & Service Organizations (Youth Hockey League, The Falls Players, American Red Cross, Etc)
Individual Members (Not involved in business)

Secondary Businesses – Please complete a separate sheet for additional businesses

Click to fill out this short form and submit your payment.