Membership Application

Do you have a Chesapeake Alliance member sponsoring you?(Required)

Yes

Name of Sponsor(Required)

Applicant Name(Required)

First Last

Applicant Business Name(Required)

Applicant Title(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Other organizations you are affiliated with

Do you hold any political office?(Required)

Yes

Enter your political office(Required)

What Interests You About Joining the Chesapeake Alliance?(Required)

Are you willing to be an advocate for the City of Chesapeake?(Required)

Yes

Chesapeake Leadership Circle dues are $1,000/year and used to fund advocacy events at local venues.

Would you like to join our mailing list?(Required)

Yes

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