Membership Application Form Membership Category* Business Membership (Registered business in NS) - $100 Individual Membership (Individual or Sole Proprietor age 18 to 64) - $30 Senior Membership (Age 65 +) - $20 Student Membership (Age 18+, enrolled in post secondary) - $20 Youth Membership (Non voting membership, under age 18) - $20 Association Membership (Groups, Clubs, Societies, Associations) - $50 Membership Type*Associate memberships are available to individuals, businesses, and associations residing outside of the geographical boundaries of the MHACCCA, or are otherwise ineligible for full membership, but wishing to support the chamber or receive benefits available to members (medical/dental coverage, etc...). Associate memberships are non-voting. Full Membership Associate Membership (Non-Voting) Total $ 0.00 CAD Business/Association InformationBusiness/Association Name* Business/Association Mailing Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Business/Association Email Business/Association PhoneIndustryAccounting/FinanceAdvertising/Public RelationsAerospace/AviationArts/Entertainment/PublishingAutomotiveBanking/MortgageBusiness DevelopmentBusiness OpportunityClerical/AdministrativeConstruction/FacilitiesConsumer GoodsCustomer ServiceEducation/TrainingEnergy/UtilitiesEngineeringGovernment/MilitaryGreenHealthcareHospitality/TravelHuman ResourcesInstallation/MaintenanceInsuranceInternetJob Search AidsLaw Enforcement/SecurityLegalManagement/ExecutiveManufacturing/OperationsMarketingNon-Profit/VolunteerPharmaceutical/BiotechProfessional ServicesQA/Quality ControlReal EstateRestaurant/Food ServiceRetailSalesScience/ResearchSkilled LaborTechnologyTelecommunicationsTransportation/LogisticsOther# Employees / # MembersBusiness/Association Website Business/Association Bio (100 words or fewer)Contact InformationEnter your contact information below. If you are completing a membership form for a business/association, please enter the contact information for the business/association representative.Name* First Last Civic Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone 1*Phone 2Email* Enter Email Confirm Email Consent* I agreeBy checking the above box, I agree to abide by the MHACCCA By-Laws and agree to the MHACCCA Privacy Policy. And I hereby give my consent for the Musquodoboit Harbour and Area Chamber of Commerce & Civic Affairs to use my contact information as stated above in it’s promotional activities (including promotion on its website, publications or other promotional activities). I understand that the Chamber of Commerce sometimes shares its membership list with similar groups in its promotional activities and agree to this practice for that end.Credit Card* MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Total $ 0.00 CAD
