Okeechobee Main Street Inc. - Community Partner Application

Community Partner Application

Partnership Online Application

Applicant Information

Are you applying Privately or as a Business? required Privately Business

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

Zip Code required

Web Address

Fax Number

Involvement

Are you interested in working on a Committee? required

Are you interested in Volunteering? required

Payment Information

Membership Type required

Payment Options required Now
Add To Cart

Now: Allows you to pay now.

Add To Cart: Allows you to add this to the shopping cart, so you can pay for multiple items at once.

Billing First Name

Billing Last Name

Billing Address Line 1

Billing Address Line 2

Billing City

Billing State

Billing Zip

Card Type required Visa

Card Number

Exp Month

Exp Year

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

Partnership In Person Payments (Office Use Only)

First Name required

Last Name required

Company Name

Phone number required

Email address required

Street address for Businesses/NonProfits

City, State, Zip

Business/NonProfit Website

Are you interested in working on a Committee? required

Are in interested in Volunteering? required

Membership Type required

Payment Method required

This is only used when paying at the office IN PERSON. If paying with credit card, use the form above. required

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Community Partner Application

Partnership Online Application

Partnership In Person Payments (Office Use Only)

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