100 Strong Bandon Signup | Welcome to Bandon, Oregon

A Note about Privacy: Information collected on this form is for internal records only. 100 Strong Bandon promises not to share your contact information with any outside party.

You may, alternatively, complete a membership form in person or print this page and drop it off at the Bandon Chamber of Commerce, 300 2nd St., in Old Town Bandon OR.

Contact Info

Name*

First Last

Address*

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

Email*

Primary Phone*

Work
Cell
Home

Secondary Phone

Work
Cell
Home

Agreement

Electronic submission of this agreement is an honor pledge, not a legally binding agreement. I certify I am 18 years of age or older.

Agree - 18 or older

Agree

I understand that I am making a commitment to 100 Strong Bandon to make a minimum annual donation of $200 ($50 donation or more at each of four quarterly meetings). These donations will be made directly to local 501(c)(3) charitable organizations in the Bandon area.

Agree - Commitment

Agree

I understand that if I am not able to attend a quarterly meeting, I will provide my donation to another member to deliver to the meeting, or mail a check, payable directly to the designated charity, in advance of or within 10 days following the meeting; mail donations to Bandon Chamber of Commerce, Att. 100 Strong Bandon, PO Box 1515, Bandon, OR 97411.

Agree - Attending Meetings

Agree

I understand my commitment will automatically renew, for successive one year periods, unless written or email notice is given.

Agree - Automatic Renewal

Agree

I agree to release of my name and photos taken at 100 Strong Bandon events for unpaid use by representatives of 100 Strong Bandon and/or the Bandon Chamber of Commerce to promote the group on the chamber website, group social media accounts, and/or in news press releases or articles.

Agree - Release

Agree

Name

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100 Strong Bandon Membership Application

Contact Info

Agreement