Membership Application
To apply for membership in the Perry County Area Chamber of Commerce, please complete all questions.
Business Name
Owner
First Name
Last Name
Contact Person
First Name
Last Name
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Billing Address, if different from Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone
-
Area Code
Phone Number
Cellular Number
-
Area Code
Phone Number
Website
Hours of Operation
Services Your Business Offers
Permission to post above information on chamber website
Yes
No
Please check appropriate annual investment
*
$250.00 - Financial Institutions
$50.00 Civic Groups, Churches, Schools, Nonprofits with no paid staff
$50.00 - 1-3 employees
$100.00 - 4-6 employees
$150.00 - 7-10 employees
$200.00 - 11-20 employees
$250.00 - 21-30 employees
$300.00 - 31-50 employees
$350.00 - 51-75 employees
$400.00 - 76-100 employees
$500.00 - 101-150 employees
$600.00 - 151-400 employees
$700.00 - 401 employees or more
$35.00 - Single Retired or individual membership
$50.00 - Couple - retired or couple membership
What Committee Would You Like to Work With?
Economic Development
Government Affairs
Community Affairs
Membership Support and Development
E-mail - Placing your email address and then submitting your application is the same as signing the application. Thank you very much for your application, which will be presented to the Board of Directors upon receipt of your annual investment.
*
Application Date
-
Month
-
Day
Year
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