membership application note this information is used for the directory plaque newsletter website and other marketing materials entered as printed business name _________________________________________________________________________________________ address __________________________________________city state zip _________________________________________ township boro county _____________________________________________________________________ phone 1 ____________________________ 2 fax __________________________ general e mail _______________________________________ web ______________________________________ preferred communication choose one ___ would you like to be added chamber broadcast email list ___yes ___no date established ____________ number of employees full time ______ part seasonal category listing s options on reverse ______________________________________________________________________ st complimentary additional listings are 50 each briefly describe service your provides ______________________________________________________________ ______________________________________________________________________________________________________ owner president ceo or manager _________________________________________________________________ main contact __________________________________________ __________________________________ staff receive mailings put y n ____________________________________________________________________________________________________ 3 please attach any names with form joined ___________________________ referred by ____________________________________________ i am joining following reasons null economic development programming tourism legislative initiatives small programs networking people what going in
