LEETONIA-WASHINGTONVILLE AREA
CHAMBER OF COMMERCE

APPLICATION FOR MEMBERSHIP

 

TYPE OF MEMBERSHIP             BUSINESS_______ASSOCIATE_______

BUSINESS______________________________________________________________
ADDRESS_______________________________________________________________
PHONE_________________________________________________________________
FAX____________________________________________________________________
# OF EMPLOYEES________________________________________________________

NAME__________________________________________________________________
HOME ADDRESS__________________________________________________________
HOME PHONE____________________________________________________________

PLEASE LIST THE AREAS OF THE CHAMBER THAT YOU ARE INTERESTE IN:

_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

REGULAR MEETINGS ARE HELD ON THE FOURTH TUESDAY OF EACH MONTH. CONTACT MARCIA HAZEL (330-427-2899) FOR TIME AND LOCATION.

DUES  AMOUNT PAID_____________DATE_____________CHECK#_________________

CASH__________________RECEIVED BY_______________________________________

BUSINESS- # OF EMPLOYEES                                     ANNUAL DUES
             1 TO 5                                                        $60.00
           6 THRU 10                                                     $80.00
          11 THRU 30                                                     $100.00
          31 THRU 50                                                     $120.00
          51 OR MORE                                                    $140.00

ASSOCIATE MEMBER - EACH                                         $25.00

SEND DUES TO:  KRISTEN FIGG 712 COLUMBIA ST., LEETONIA, OH 44431

PLEASE MAKE CHECKS PAYABLE TO:   LEETONIA-WASHINGTONVILLE AREA CHAMBER OF COMMERCE OR L.W.A.C. OF C.