(Print, fill out, fax or mail)

MEMBERSHIP APPLICATION

We request membership in the East Side Chamber of Commerce, a not for profit corporation, organized for the development of Business, Industry, Transportation and Community Improvement in the Greater Calumet area.

NAME of Business, Organization, or Individual: ____________________________________________________________________

Individual: $35.00 Small Business (1-5): $75.00 Large Business $100.00 Non Profits: $60.00
Utilities and Financial Institutions: $500.00 Industrial: $250.00 Professional and Contractors:$100.00

Enclosed is a check for applicable dues in the amount of $ ______________

If our application is approved, please notify _______________________________________________________________________
who will act as our representative in the Chamber’s activities.

Address: ________________________________________________________________________________________________

City: ___________________________Business Phone:____________________ Fax:____________________________________

Home Phone: _____________________Cell Phone:________________________ Pager:_________________________________

E-mail: ____________________________________Web Address: __________________________________________________

Contact Preference: Fax ______ E-mail:______ Mail:____________

Please DO NOT WRITE BELOW LINE

_________________________________________________________________________________________________________

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PRESENTED TO THE BOARD of DIRECTORS

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BOARD’S RECOMMENDATION

DEDICATED TO THE DEVELOPMENT OF BUSINESS, INDUSTRY,
TRANSPORTATION and COMMUNITY IMPROVEMENT