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Okeechobee Main Street
>
Community Partner & Membership
> Community Partner Application
Community Partner Application
Online Community Partnership Application
Applicant Information
Are you applying Privately or as a Business?
required
Privately
Business
Non-Profit
First Name
required
Last Name
required
Company Name
Only enter if applying as business
Phone Number
required
Email Address
required
Street Address
required
City
required
State
required
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Conneticut
DC - Washington, D.C.
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
AS - American Samoa
GU - Guam
MP - Northern Mariana Islands
PR - Puerto Rico
VI - Virgin Islands
FM - Federated States of Micronesia
MH - Marshall Islands
PW - Palau
AA - America
AE - Europe
AP - Pacific
Zip Code
required
Web Address
Fax Number
Involvement
Select Your Preferred Committee
Promotions
Arts and Culture
Design
Membership
Volunteer
Indicate Your Willingness to Volunteer
Yes
No
Contact Me
Payment Information
Membership Type
required
Private: Friend - $25.00
Private: Family - $50.00
Non-Profit Organization - $50.00
Bronze Partnership - $100
Silver Partnership - $250.00
Gold Partnership - $500
Platinum Partnership - $1000
Billing First Name
Billing Last Name
Billing Address Line 1
Billing Address Line 2
Billing City
Billing State
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Conneticut
DC - Washington, D.C.
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VA - Virginia
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
AS - American Samoa
GU - Guam
MP - Northern Mariana Islands
PR - Puerto Rico
VI - Virgin Islands
FM - Federated States of Micronesia
MH - Marshall Islands
PW - Palau
AA - America
AE - Europe
AP - Pacific
Billing Zip
Card Type
required
Card Number
Exp Month
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
Exp Year
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
Card Verification #
Visa, MasterCard, or Discover:
the three-digit card verification number can be found on the back of the card.
American Express:
the four-digit card verification number can be found on the front of the card.
Verification
required
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Okeechobee Main Street, Inc. | 111 NE 2nd Street | Okeechobee, Florida 34972
Phone 863-357-6246 | Email
info@okeechobeemainstreet.org
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