First Name*

Last Name*

Date Business Joined Chamber

Date Business Started*

Date Business Joined Chamber

Company*

Main Contact*

Title

Street Address*

City/State/Zip*

Mailing Address

City/State/Zip

Phone*

Email*

Fax

Website

Total Full Time Equivalent Employees*

Primary Business Category*

Secondary Business Category

ANNUAL MEMBERSHIP INVESTMENT SCHEDULE
"To create and promote economic prosperity in the south metro region."
Vision for the Wilsonville Area Chamber of Commerce

Membership Dues & Benefit Levels (We will contact you about payment)
Level 1 Membership: CONNECTING ... $30/mos. ($360.annual)
Level 2 Membership: BUILDING ... $50/mos. ($600.annual)
Level 3 Membership: LEADING ... $100/mos. ($1200.annual)

Desired Membership Level*
LEVEL 1: CONNECTINGLEVEL 2: BUILDINGLEVEL 3: LEADING

Reasons for Joining the Chamber*
Advertising/Free PubliclyBenefits & DiscountsCommunity InvolvementCredibilityGovernment AdvocacyIncreased BusinessEducational OpportunitiesNetworkingReferralsEconomic DevelopmentOther

REPRESENTATIVE INFORMATION

Name*

Title

Mailing Address*

City/State/Zip*

phone*

fax

Email*

*If you have more representatives, fill accordingly in the bottom text box

Additional Information

By submitting this application, applicant is agreeing to the following:

Membership dues investment is non-refundable and is a 1 year investment.
Membership plaques are the property of the Chamber and are required to be returned if membership is canceled for any reason.
Membership with the Chamber may be revoked according to the terms set forth in its bylaws.
100% of your membership investment is usually deductible as an ordinary and necessary business expense.
Dues paid to the Chamber are not a charitable tax deduction for federal tax purposes.

By completing and submitting this form you are approving your authorized signature.

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