Membership Assessment & Inquiry Form - Surprise Regional Chamber of Commerce
Making an investment in the Chamber is an important decision. All Information will remain confidential. We appreciate that every business has different needs, interests, priorities, and budgets. Please answer a few questions, and we will get back to you ASAP!
*
- Required Field
First Name *
Last Name *
Email *
Business Name *
Owner Name *
Company Name *
Email *
Best phone number to reach you (cell phone) *
What best describes your business phase? *
-- No Selection --
Start-Up
Rapid Growth
Growing
Mature
Declining or Re-Birth
Choose 1
How many employees are in your business? (employees who receive a W-2) *
-- No Selection --
No employees under me
1-2
3-9
10-49
50-99
100-499
500 - 999
1,000 +
Choose 1
Do any of the following situations apply to your business? (check all that apply)
Select all that apply
Desire to strategically enhance our community engagement and involvement
Have some important and/or on-going legislative issues or concerns
Expanding our marketing area into the NW Valley
Launching a new product or service
Need to re-brand or reposition our product or service
We are opening up a new business (Brick and Mortar)
None of the Above
How do you currently reach your target audience?
Select all that apply
Print Media (newspaper/magazine)
Broadcast media (TV/radio)
Public Relations (Free Public Service Announcement, editorials, etc)
Internet/Interactive (Website, social media)
Direct Marketing ( Direct mail, telemarketing)
Sales Promotions (Coupons, specials, deals)
Events and Sponsorships
Word of Mouth
Personal Selling
How critical is it for your business to engage pro-business public policy at the local, state, or federal level?
-- No Selection --
Extremely critical
Very critical
Somewhat critical
Not so valuable
Not at all valuable
Choose 1
Which of the following statements do you STRONGLY AGREE with? *
Select all that apply
I am a community stakeholder with a strong interest in what happens in our community.
I am interested in tackling business issues facing our community (the economy and regulations).
I am interested is solving or learning about major issues facing our community.
I value political action and government relations activities of the Chamber..
I am less likely to show up to Chamber events because of my schedule.
I have a vested interest in the region and view myself as a community investor.
Getting my brand name/logo out in the community is important.
I am willing to pay for advertising.
I am interested in sponsoring events or programs.
Attending free events is very important to me.
Getting my business found on the local internet searches is very important to me
Having a simple, very budget friendly website set up ASAP is important
I have more time than money.
What title best describes your role in the business?
-- No Selection --
Owner, President, CEO, Partner (or C-Suite)
Store Manager/Senior Executive/VP/Department Head
Home-based Business/ Multi-Level Marketing Business Operator
PR, Marketing Department or Sales Representative
Other
Choose 1
After completing the form, you will receive a confirmation email, and be redirected to my Calendar Widget. Please schedule a time that is convenient for you to have a short 20-30 minute phone conversion. Please be sure to include your cell phone information on the form, and expect a phone call at the date and time you selected.
I look forward to chatting with you. Thank you!
Mary
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