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Chamber Membership Application – Printable

Please print a copy of this form, complete, and submit to us by mail.

Business or Organization Name: ______________________________________________

Your Name: (Mr. Ms. etc.) ______________________________________________

Business Address: (For use online and in Business Directory)

______________________________________________

______________________________________________

Business Phone: ___________________________________

Fax: ___________________________________________

Mailing Address: ___________________________________

______________________________________________

______________________________________________

Other Phone/Info: ______________________________________________

E-Mail:___________________________________________________

Web Address: ______________________________________________

Business Category: (Health Care, Real Estate, Crafts, etc.)
For Directory and Website listing, you can select up to 3 categories free.

______________________________________________

______________________________________________

______________________________________________

Description of Business Activity:
Please limit to 20 words. .50 cents for additional words.

______________________________________________

______________________________________________

______________________________________________

Number of Employees: ______________________________
Business Entities (Corporation, LLC, Partnerships, etc.) should pay dues based on number of employees.

I would like to join the Chamber as a:

Business/Industry

  • 1-4 Employees $40.00
  • 5-8 Employees $75.00
  • 9-14 Employees $90.00
  • 15-25 Employees $120.00
  • 26 + Employees $270.00

Professional

  • (Lawyer, Doctor, Dentist, Vet, etc.) $85.00
  • Real Estate $100.00
  • Financial (Bank/Utitilty) $220.00
  • Educational $120.00
  • Non-Profit Organization/Club/Church $35.00
  • Individual (Non-Business Listing $25.00

In Addition I would like to purchase:

  • Banner Ad on Chamber’s Website $30.00/month
  • Hot Link on Chamber website $30.00/year

Total Amount Due: ______________________________________________

Amount Enclosed: ______________________________________________

Today’s Date: ______________________________________________

Dues are not refundable! Please note that memberships run from January through December. After July 1, dues are 1/2 for first time members only. Inquiries may be made by calling 689-9351 and/or 680-9546. Or, e-mail the chamber at: info@madisoncounty-nc.com

Please mail your check along with this application to:
Madison County Chamber of Commerce
PO Box 1085, Mars Hill, NC 28754

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