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100 Strong Bandon
Membership Application
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
Email
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