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10677 HWY 15-501, Southern Pines, NC 28387
(910) 692-3926, (910) 692-0619 Fax
info@moorecountychamber.com

Member Application

Welcome to the Moore County Chamber of Commerce! If you have any questions when filling out this application, or would prefer to fill out a hard copy of the application, please contact Holly Neal, Membership Development Director at 910.692.3926 or hneal@moorecountychamber.com

Business Information

Company Name: *

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category:

Employees:

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State:

Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter YouTube Houzz

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter YouTube Houzz

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 5 plus 1?: *

Print Application

Hours of Operation
Monday – Friday
9:00 a.m. – 5:00 p.m.

(910) 692-3926 Phone
(910) 692-0619 Fax
info@moorecountychamber.com

Moore County Chamber of Commerce
10677 Hwy 15-501
Southern Pines, NC 28387

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