Join The Sarasota Young Professionals

Please contact Mimi Cirbusova at mcirbusova@sarasotachamber.com, to receive information on joining the Young Professionals Group.

Employer Information

Organization Name *

Address 1 *

Address 2

City *

State *

Zip *

Your Info

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Title

Phone *

Email *

Billing Address (if different)

Street

City

State

Zip

Mailing Address (if different)

Street

City

State

Zip

YPG Committees (check box if interested)

I am interested in learning more about YPG Committees

Membership Investment

Annual Membership Investment

$60.00

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost

Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)

tempValueForDropDown1

Membership Type: *

Primary Directory Category *

Additional Directory Categories

Primary Directory listing is complimentary
Up to two additional Directory listings are complimentary
After two, additional Directory listings are $35 each

**Hold CTRL on your keyboard to select multiple categories**

Number of Full Time Employees:

Number of Part Time Employees:

Number of Rooms (Accommodations):

Number of Seats (Restaurants):

Number of Associates (Realtors, Attorneys):

Number of Locations ($35/add. location):

Millions in Assets (Financial Institutions):

Enhanced Membership ($50):

Additional Categories Cost

One-Time Application Fee

Tax

Payment Type *

NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.

Credit Card Information

Credit Card Type * MastercardVisaDiscoverAmex

Credit Card Number *

Name On Card
Security Code
Valid Through
	Use Address Above
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address

Please click submit only one time. The transaction may take several seconds.

the greater sarasota
chamber of commerce