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MEMBERSHIP APPLICATION REQUEST |
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Note: * indicates required field
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1. Contact Information |
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Firm Name (DBA Name):*
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CEO/Manager Representative Name:* |
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Title: |
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E-mail: |
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Web Site: |
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Street Address: |
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City: |
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State: |
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Zip: |
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Phone (incl area code):* |
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Fax (incl area code): |
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2. Business Category Listings |
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To select the Category that best describes your business
for your online listing,
click here. Once you have found a category, return
to the application and type the category in the field
below. |
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Business Category:* |
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If your Business Category is the following, you will
need to call the Chamber to discuss the Investment
schedule: |
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Apartments/Condominiums
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City/County
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Hotels/Motels
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Hospitals/Nursing Homes
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Restaurants
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List additional company
representative(s): |
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Name: |
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Title: |
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Email: |
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Name: |
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Title: |
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Email: |
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Name: |
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Title: |
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Email: |
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Name: |
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Title: |
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Email: |
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# of Full-Time Equivalent Employees: |
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Privately Owned company?: |
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Year Firm Established: |
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For new members their is a new
member administrative fee
of $30. |
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3. Investment Formula |
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(a) Base membership dues (includes one employee):* |
$
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(b) # of employees X $10.00 =
*
(Note: Fair-share
membership dues are based upon total
number of employees.) |
$
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(c) $5.00 per employee
starting at 101 employees
* |
$
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Total investment*
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$
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Check if you would like a call from a Chamber
representative to further discuss membership
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Your membership investment is an 85%
tax-deductible business expense
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4. Credit Card Information |
Credit Card Type:
*
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Credit Card Number:
*
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Note: *
indicates required field
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