Membership Information Form

Chamber Membership Application

The Viroqua Chamber is a non-profit grass-roots organization driven by the energy and enthusiasm of our volunteer committees and board of directors. The Viroqua Chamber does not receive state or federal funds but rather is sustained by memberships of local businesses, government, and individuals in and around the City of Viroqua. It is only with these contributions that the Viroqua Chamber can continue as a community and small business advocate working at the local, state and national levels.

As a member of the Viroqua Chamber, you are choosing to be a partner in building a stronger, thriving, more vibrant community. You are promoting economic growth and providing opportunities for all businesses and organizations to prosper. With your contribution, the Viroqua Chamber can continue as your community and business advocate, working at the local, state, and national level to ensure that Viroqua continues growing forward.

Chamber Member Application

Business Name

Owner

First Name

Last Name

Contact Name

First Name

Last Name

Business Address

Street Address

Address Line 2

City

State

Zip

Mailing Check

Check here if mailing address is different than physical address.

Mailing Address

Street Address

Address Line 2

City

State

Zip

Phone

Cell Phone

Website/URL

Paragraph

Member Fee Structure

Total

Payment Options

Pay On-line

Pay by Check

Consent

I/We pledge the above selected amount to the Viroqua Chamber Main Street for the 2025 calendar year. I understand that upon checking this box I will be invoiced for the above amount. I understand that this agreement renews automatically and that I will be invoiced annually. I understand that I can terminate this agreement at anytime.

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