Chamber Application Fields marked with a * are required. Individual or Business Name: * Please describe your business or organization * Number of Employees * Web site: Date Business Established (m/d/yyyy) * Primary Contact Name: * Email * Phone * Fax: Alternative Phone (or cell): Alternative Contact Name: Business Street Address * City * Post Code * Membership Rates Membership Fees are based on the number of employees. Two part-time employees equal one full time employee. Membership fees are for the calendar year from the date of payment. Please check the appropriate box: Junior Member (<19) $40 Individual/Non-business $60 Non-Profit Organization $60 Self-employed $100 Business 1-3 employees $150 Business 4-6 employees $170 Business 7-20 employees $250 Business 21-50 employees $295 Business more than 50 employees $375 We will contact you for your payment details. Date of application * Please answer an Anti-Spam question - What is the total of 2 + 2 *
