Ambassador Interest Form

First Name *
Last Name *
Email Address *
Phone Number *
Name of a charity you would like to support. (This can be added or changed later.)
How many businesses and nonprofits do you estimate you can personally introduce? *
* Preferably, these are organizations with 10 or more W2 employees, but less than 500 full time as of 2019.
Do you know an association or company that serves a significant number of businesses or nonprofits with 10 or more employees? *
Are you a member of the Chesterfield Chamber of Commerce? *
Anything else you would like us to know?
Asterisk (*) fields are required.