262-728-5095
Please complete this form in its entirety and mail it,
along with your membership investment, to the chamber so that we can keep our
files current on you, our valued Chamber member.
ENCLOSED IS MY MEMBERSHIP INVESTMENT FOR see
investment schedule: $__Call for investment schedule_________________
Please include the $25.00 administrative fee, for new members only.
Please include the $35.00 fee to link our website.
DATE : _________________________
DIVISION # ___________
NAME OF
BUSINESS:_______________________________________________________________
CONTACT
PERSON:________________________________________________________________
CHIEF EXECUTIVE OFFICER:____________________________________________
BUSINESS ADDRESS (include
P.O. Box #):_______________________________________
CITY:
____________________________________ STATE: __________ ZIP:___________________
TELEPHONE:
_______________________________ FAX:__________________________________
E-MAIL:
_________________________________ WEBSITE:________________________________
NUMBER OF FTE (full
time equivalent) EMPLOYEES: ________________
BRIEF DESCRIPTION OF YOUR
BUSINESS:__________________________________________
___________________________________________________________________________________
PARENT COMPANY NAME:______________________________________________________
CONTACT
PERSON:_____________________________________________________________
BUSINESS ADDRESS (include
P.O. Box #):_____________________________________________
CITY:
_____________________________________ STATE: _________ ZIP: _______________
TELEPHONE:
___________________________ Submit invoices to parent company?__________
|
Payment
options:
cVisa
c
Mastercard
Card #_____________________________ Exp. Date ___________
Signature: ___________________________________________ or make your check payable to and return to
the Delavan - Delavan Lake Area Chamber of
Commerce 52 E. Walworth Ave., Delavan, WI
53115 |
Other links: Membership Application | Board of Directors | Community Guide | Map |
Delavan - Delavan Lake Area Chamber of Commerce
52 E. Walworth Avenue, Delavan, Wisconsin 53115
262-728-5095 / 1-800-624-0052
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