Milford Chamber Online Membership Application

Company Information
Company:
*
Address Line 1:
*
Address Line 2:
City:
*
State:
*
Zip:
*
Phone 1:
*
Phone 2:
Fax:
E-mail:
*
Website:
Bus. Category 1:
Bus. Category 2:
50.00
Bus. Category 3:
25.00
Full-time Employees:
*
Part-time Employees:
*
Additional Business Information
Business Description:
48.00
25.00
Members-only Account Login
Members-only allows you to update your information online via a secure login.
Admin E-mail:
*
Password:
*
Verify Password:
*
Contacts
Primary Contact
Prefix:
First Name:
*
Last Name:
*
Suffix:
Familiar Name:
Title:
 
Billing Contact
 
Additional Representative
 
Additional Representative
 
Additional Representative
 
Additional Representative
 
Member Investment Schedule
2 part time employees = 1 full time emlpoyee
Employees
Amount
1-5
379.00
6-10
449.00
11-24
529.00
25-50
639.00
51-100
779.00
379.00
Processing Fee
$25.00
Total:
$0.00
The applicant hereby agrees to become a member of the Milford Regional Chamber of Commerce and agrees to pay the annual membership investment plus any applicable additional fees noted. This investment entitles the company to full membership in the Milford Chamber of Commerce, Inc. with all attendant services and benefits, when accepted by the Board of Directors. The Investment Schedule is subject to yearly adjustment. Dues and marketing selection(s) are renewed automatically on an annual basis unless cancelled in writing. The Chamber reserves the right to cancel membership at any time.

My company also gives permission for any and all use of my company name, employee name(s), recognition in publications and photographs, news media, collateral material and the Milford Chamber website, in regard to any or all Milford Chamber events and programs. My company also gives the Chamber permission to communicate with my representatives by fax and email and to publish company address(es) in Chamber publications and on the Chamber website.
Security Code:
Please enter the security code above.
  
Powered By CC-Assist.NET

Top ] [ Back ]