* Required Field
Business Name:*
Contact Person:*
Contact Title:
Billing/Mailing Address:
City:
State: Zip:
Physical Address:*
Telephone:*
Fax:
E-mail:*
Website:
Full Time Employees:
Part Time Employees*:
Total Full Time Employees:
* = Calculate the number of part time employees that equal one full time employee.
West Bend Area Chamber of Commerce 304 South Main Street, West Bend, WI 53095 Telephone: (262) 338-2666 (888) 338-8666 Fax: (262) 338-1771 Email: info@wbachamber.org