MEMBERSHIP APPLICATION FORM

To join the Leatherhead & District Chamber of Commerce, please complete and submit the online application form below.

Please make your cheque payable to 'The Leatherhead & District Chamber of Commerce' and send your membership subscription payment to:

Membership Administation, Leatherhead & District Chamber of Commerce, 49 Stag Leys, Ashtead, Surrey KT21 2TQ

The rates are on the form or you can click HERE to go to our Subscription Rates page.

Business name
Title Mr/Mrs/Miss/Ms
First Name
Initials
Surname
Position in Buisness
Department in Business
Business Address
Postcode
Telephone No.
Telephone No. 2
Direct line (if applicable)
Mobile No.
Email address
Website address
Fax No.
Contact 2: Add full name / Initials / Job title / Tel & Email address
Business description (as you want it to appear on our website)
Business category
Select & write up to 2 additional categories from the dropdown or create aother category
Membership period
Membership rates (Joining Jan/Feb/Mar)
Membership rates (Joining Apr/May/June)
Membership rates (Joining July/Aug/Sept))
Membership rates (Joining Oct/Nov/Dec)