Introduction

2008 Membership Application

Member Information

	Name of Organization/Business/Public Entity or Individual
	-------------------------------------------------------------------------------
	Street or P.O. Box Address
	------------------------------------------------------------------------------
	City,State and Zip
	------------------------------------------------------------------------------
	Billing Address
	------------------------------------------------------------------------------
	Type of Business
	-----------------------------------------------------------------------------
	Representative to Chamber of Commerce
	------------------------------------------------------------------------------
	Telephone Fax/Number Home Phone
	------------------------------------------------------------------------------
	E-Mail Address Website
	------------------------------------------------------------------------------

----Need a Chamber Logo -----Need a year Strip -----Need a Member Certificate

-----Receive newsletter electronically -----Advertise on Website

-----Need an Invoice

Membership Dues

	*Membership Annual Dues- Due, February 1,2008*
	Business----------------------------------$90.00
	1-5 Employees $95.00
	6-25 Employees $100.00
	25+ Employees $105.00
	Public Entity-----------------------------$58.00
	Individual----------------------------------$40.00
	Service Organization-----------------$29.00
	Auxiliary----------------------------------$10.00..with full member
	$10.00 late fee after due date for everyone

Return this completed page with a check payable to:

Check #________________ Amount_________________

Date___________________ Received by_____________

Please Volunteer, Your Chamber needs your help. Please indicate the committees in which you are interested.

---Business or Health Expo ---Business Planning ---Christmas in the Park

---Candidates Night ---Garage Sale ---Golf Outing ---Halloween in the Park

---Membership ---Newsletter ---Office Assistance ---Scholarship

---Sugar Maple Festival ---Christmas in Bellbrook ---Networking Events