REGISTER FORM - OTAYMESAOTAYMESA

Level Membership

Company Adress:

State:

Zip Code:

Company Name:

City:

Web Site:

Primary Contact (this person will be listed as the main rep in our membership directory)

Name

Alternate Contact

Company Product or Service:

Referred by:

Message:

Title

Phone:

EXT

10 Word Business Description:

Payment Method:

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-CHECK: Please make it payable to Otay Mesa Chamber of Commerce and MAIL TO: 9163 Siempre Viva Rd, Suite I-2, San Diego, CA 92154

-CREDIT CARD: Please call us to process your payment over the telephone at (619) 661-6111 Ext. 5

CONTACT US

8100 Gigantic St., Building 4100
Office 4106
San Diego, CA 92154