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Business of Family Name:
*
First and last name of the person competing.
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Mailing Street Address
*
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Mailing City
*
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Mailing Zip
*
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Physical Street Address
Include physical address if different from mailing.
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Physical City
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Physical Zip
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Email
(Email needed to send you confirmation when submitting this form.)
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Website
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Number of Employees
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Year Established
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Type of Business:
Please include products and services provided.
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May we include you / your business on our Facebook page?
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Owner's Name
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Manager's Name
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Please select the membership type
*
Individual / Family: $75
Business 1 employee: $100
Business 2 - 15 employees: $150
Business 16 and up employees: $200
Financial Institutions / Corporate: $600
Nonprofit / Organizations: $75
Hospital / Schools: $600
Hunting Lease: $100
Payment Confirmation
*
Confirm the amount you are paying.
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I will be providing payment using:
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(Cash and Check must be delivered to the Coleman Chamber of Commerce.)
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