Online Enrollment-Affiliate Participant

Affiliate Registration allows your organization access to the Office Depot and Blue Cross Blue Shield of Michigan programs.
Please use the form below to complete your registration for the Detroit Regional Chamber Affiliate Participation Program.
Upon completion of this form, your organization will be registered at no cost for the Office Depot savings program.

The Registration Verification form will be emailed to the address listed in the email field below. Please use this verification form as proof of membership for your BCBSM paperwork.
For questions or more information, please contact the Insurance Service Center at (877) 227-1500.

Affiliate Participant Registration
Company :
First Name :
Last Name :
Title :
Email :
Phone :
Website :
Industry :
No of Employees :
Address 1 :
Address 2 :
City :
State :
Zip Code :
Membership Affiliations :
Franchisee :
Multiple Locations :
HR/Benefits Contact :
HR/Benefits Contact Email :
Office Supply Contact :
Office Supply Contact Email :
Networking/Events Contact :
Networking/Events Contact Email :