Application for Membership

Name of business/individual/family:
Mailing address:

Telephone Number:		Fax Number:
Email address:		Web Address:

Following information is only applicable to business applications:

Type of Business:
Place of Business:

No. of full-time employees:

Membership Fee (See rate schedule below):

To be represented by:

Please indicate any additional businesses that you own and would like to add to your Chamber membership (a rate of $75 each applies): ____________________________________________________________________________

Please indicate any employees that you would like to include for Individual membership (a rate of $30 each applies): __________________________________________________________________________________________

Memberships are for one year from the date of your original anniversary date and will be due for renewal on the anniversary month of the original membership.

Name(s) of any Chamber(s) of Commerce in which a current or previous member:

Thank You For Your Membership!

SCHEDULE OF DUES

Classification Dues

Annual Dues

Individual/Family/Non-Profit/School/Church/Civic Organization

$30.00

Professional/Small Business (1-5 employees)

$65.00

Professional/Medium Business (6-10 employees)

$125.00

Professional/Medium-Large Business (11-15 employees)

$200.00

Professional/Large Business (16-19 employees)

$225.00

Professional/Extra Large Business and Multiple Businesses under same Ownership (20 or more employees)

$300.00

Each additional Business added under Multiple Business

$75.00

Each additional Individual Member added under a business or Multiple Business

$30.00