Member

Welcome and thank you for applying for membership with Greater Fort Wayne Inc! All membership applications are subject to approval and online membership payments may take up to 24 hours to settle. Payment receipts are available upon request.

IMPORTANT NOTE: Your application must be completed in its entirety in order to be processed. Incomplete applications will not be saved.

The security of your cardholder data is important to us. Please click the icon below for more information on how Greater Fort Wayne Inc. protects merchants and consumers using our website.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website: *

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

Referred By:

Date Company Established: *

Minority-owned business:

Woman-owned business:

Veteran-owned business:

Is your company less than three years old?:

Is your company a nonprofit organization?:

Is your company a member of another chamber of commerce?:

If yes, which?:

How did you hear about GFW Inc. membership?:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook Instagram Twitter

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Print Application

Member Application

Mailing Address

Address

Address