Complete and return this membership application along with your annual dues and experience the many advantages of partnership in the leading regional economic development and business advocacy organization.

As a partner, you have the opportunity to expand your network through participation in events and referrals from the Chambers information desk and website. You also gain access to resources important to the development of your business and your workforce, and many tools to bring greater exposure to the products and services you offer.

Membership in the Chamber is considered a necessary business expense by the Internal Revenue Service. Because we are a lobbying organization, 92% of your annual dues are tax-deductible.

*Required fieldsMembership Application
*Firm Name:	Business Established:
Ownership (check all that apply):	Female Male Caucasion African American Hispanic Asian Other
Maling Address
*Address:	*City:
*State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	*Zip:
*Key Contact:	Title:
Physical Address
Address:	City:
State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip:
*E-mail:	Internet Address:
*Phone Number:	Number of Employees:
*Business Classification:	Financial Institution Total Annual Deposits
Describe Goods or Services:	Hotel/Motel Number of Rooms Apartments Number of Units
Annual Investment Schedule Employees Over 1000 Annual Dues 1-10 $300 11-20 $400 21-50 $500 51-100 $600 101-200 $700 201-1000 Employee count rounded up to the nearest hundred, additional $100 per hundred over 200 Over 1000 $2,500	Investment Worksheet: *Annual Dues: Upgrade to Gold x 50% Upgrade to Platinum x 200% One-time Administrative Fee: $25 (non-refundable) *TOTAL INITIAL INVESTMENT:
Payment Information
*Payment Type: Visa Mastercard American Express Discover	*Card Number *Expiration *CVV Code

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Gold Member: requires minimum investment level of 150% of dues schedule. Any member investing more than $2,500 is automatically qualified, regardless of dues schedule.

• Admission to Regional Power Meet for key contact and one guest
• Admission to Annual Meeting for key contact and one guest with RSVP
• Admission to Industry of the Year and Small Businesses of the Year Awards Luncheon for key contact with RSVP
• Special recognition in Chamber printed and electronic publications

Platinum Member: requires minimum investment level of at least 300% of dues schedule. Any member investing more than $10,000 is automatically qualified, regardless of dues schedule.

• Admission to Regional Power Meet for key contact and three guests
• Admission to Annual Meeting for key contact and three guests with RSVP
• Admission to Industry of the Year and Small Businesses of the Year Awards Luncheon for key contact and one guest with RSVP

• Special recognition in Chamber printed and electronic publication