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Chamber Membership Application

Please mail or fax to: Eastern Maumee Bay Chamber of Commerce

2448 Navarre Ave, Oregon, Ohio 43616

Phone (419)693-5580 ;

Fax (419)693-9990

Date:

Name of Business:

Address:

City: State: Zip:

Phone: Fax:

Website: Email:

INFORMATION FOR MEMBERSHIP DIRECTORY & MAILING LIST

Contract Person:

Title/Position:

Phone, if different from above:

BRIEF DESCRIPTION OF YOU BUSINESS

2006 Membership Dues Structure

Membership Type:

Senior Personal Membership 60+years of age Non -Business, No Company References

$50.00

Payment Method:

Credit Card:

Expiration:

Authorized Signer:

Supporting Personal Membership under 60 years of age Non -Business, No References

$65.00

Franchise Membership