Perry County Area Chamber of Commerce - Membership Application

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:

Billing Address, if different from Mailing Address:

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
Should be Empty: