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Chamber Membership Form
**Please count 2 part-time employees as 1 full-time employee.**
Standard: 10 or fewer full-time employees:
$200.00
Select:
Item Subtotal:
$0.00
Business Name
Number of employees
Standard: 11 or more full-time employees:
$275.00
Select:
Item Subtotal:
$0.00
Business Name
Number of employees
Standard: Individual joining outside of a business:
$65.00
Select:
Item Subtotal:
$0.00
Total:
$0.00
Business Representative Information
First Name:
Last Name:
Address:
Address:
City:
State/Province:
ZIP/Postal Code:
Phone:
Email:
Payment Information:
Processing Fee Rates:
Cards:
2.9% plus $0.30
eCheck:
$0.55
Method of Payment:
Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
Change Payment Method
Submitting ...
Cancel
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SIP Version 3.09.15288; (API: 2.20)
