Membership Application
Name of Business
Contact Person
Business Address
City
State
Zip Code
Phone
Alternate Phone
Fax
Email
Website
How did you hear about the Chamber?
Describe your product or services:
If new business, when do you plan to open?
Additional information about your business:
What member of the Chamber referred you?
Membership Investment
 Corporate (251 or more employees): $1000 
 Major Business (25-250 employees): $400  
 Small Business (3-24 employees): $125 
 Micro Business (1-2 employees): $75 
 Churches / Non-Profits: $75  
 Government: $75 
 Individual: $40 
Payment Method
 Cash 
 Check / Money Order 
 Visa 
 Mastercard 
 American Express 
Credit Card Number
Expiration Date
Zip Code