|
MEMBERSHIP APPLICATION |
Business Name: _________________________________________________Date:______________
Contact Name: _____________________________________________________________________
Physical Address:_______________________Mailing Address:_______________________________
Telephone:____________ Fax: __________Email___________________________ Web site: _______________
Description (please write your description and limit it to 100 words or less)
Please indicate the categories in which your business should be listed on chamber website
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___ Business Membership $200 (billed annually, semi-annually or quarterly) Please circle your choice of payment options.
___ Multiple Business Member $100 for each business thereafter
___ Associate Member $100 (no business ownership)
___ Affilliate Member $100 (business must have primary membership with the Rawlins/Carbon County Chamber of Commerce)
Please ask about our Hometown Heroes program. Joining as a hometown hero entitles you to many amenities not included in
the regular membership.