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Pay It Forward Form

This form is used when a person or business wants to pay another business's membership dues
Contact: Keiyia George
Phone: 284-345-3513
Email: executive.director@bviccha.org
The Business You are Supporting
Enter the name of the business you would like to support
Contact Person/Representative Name
Enter 0 if you are not sure and we will call them to confirm.
Enter the amount
New or Exisiting Member *
Is this an existing member? A new member?
Supporter's Information
Your Name
Are you an exisiting member? *
Are you an existing member?
You may release my logo as supporter (we will not release who the support is for). *
I confirm that I would like to pay the dues and all fees for the business listed above and understand that I will be billed directy for such. I understand that all new membership requests must be approved by the BVICCHA’s Executive Committee as per their procedures. Once approved, I understand that the business listed within for whom I am willing to donate membership dues and fees will be contacted by the Chamber's staff regarding this application. I understand that all payments must be received before the membership can be added/renewed.

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