Membership Application Form

Membership Category*
- Business Membership (Registered business in NS) - $200
- 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 Information
Business/Association Name*
Business/Association Mailing Address*
Street Address Address Line 2 City Province Postal Code
Business/Association Email
Business/Association Phone
Industry
# Employees / # Members
Business/Association Website
Business/Association Bio (100 words or fewer)
Contact Information
Enter 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 Province Postal Code
Phone 1*
Phone 2
Email*
Enter Email Confirm Email
Consent*
I agree
By 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*

MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$ 0.00 CAD

Membership Application Form

Business/Association Information

Contact Information

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