CHAMBER OF COMMERCE OF THE MAHOPACS
APPLICATION FOR MEMBERSHIP

Fees: Annual Fee: $175.00 One-time administration fee: $25.00

	Please fill in ALL appropriate fields. Incomplete applications will not be considered.

Type of Membership: (check one)

Business

Professional

Organization

Name of Business

Street Address

City

State

Zip

Mailing Address - if different from above

Contact name

Business phone

Fax

Email

Website

	Principals of the business

Name

Home Address

Home Phone Number

Name

Home Address

Home Phone Number

Name

Home Address

Home Phone Number Would you be willing to serve on a committee?

Yes

No

If you were referred to us, by who?

	Upon pressing the SUBMIT button, application is hereby made for membership in the Chamber of Commerce of the Mahopacs, Inc. and is subject to approval by the Chamber’s Board of Directors. Upon approval, you will be contacted to facilitate applicable membership fees. This application will be submitted through a secure server.