Chamber Connectors

Name(Required)

First Last

Company Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone(Required)

Business Phone(Required)

Email Address(Required)

Which of the following Chamber committees have you participated on in the past?(Required)

Which of the following Chamber programs have you attended in the past?(Required)

NEXT – Chamber’s Young Professionals

Major Employer Forum

Professional (Executive) Dialogue Groups

Leadership Program

Supervisor Development

Lunchtime Learning

Unite for Success High School Internship Program

Unite for Success Scholarship Program

Workforce Development Workshops – Various Topics

Which of the following Chamber programs have you attended in the past?(Required)

Which of the following Chamber marketing/advertising opportunities have you taken advantage of in the past?(Required)

Why are you interested in the Connectors Committee?(Required)

What skills will you contribute to this Committee?(Required)

What is your favorite event, program, committee or advertising opportunity that you have been involved with as a Chamber member?(Required)

Does your Business/Company experience a busy season that would affect your availability during the calendar year? (If yes, please explain)(Required)

Signature(Required)

Connectors Application