|
Johnson City Chamber
of Commerce • Membership Application |
| Legal Business Name or Individual Name: _____________________________________________________________________ |
| Owner(s): ______________________________________________________________________________ |
| Contact (if different from owner): ___________________________________________________________ |
| Referred by: ___________________________________________________________________________ |
| Mailing Address: _______________________________________________________________________ |
| Physical Address (if different): ____________________________________________________________ |
|
City: ______________________________________________ State: _______ Zip: _________________ |
| Phone Number: ________________________________ Fax: ___________________________________ |
| Email Address: ________________________________________________________________________ |
| Website Address: ______________________________________________________________________ |
|
Business Classification: (See website "Business Listings by Category"): ______________________________________________________________________________________ |
|
Business description for website listing and referrals: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ |
| Are you interested in a ribbon cutting (for new members only)? yes no |
| Are you interested in becoming a Director on the Chamber Board? yes no |
| Are you interested in serving on a committeer? yes no |
Date Joined / Renewing:
____________________
|
Office Use Only
* Renewal Date &Year * Renewal Date &Year * Renewal Date &Year |
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