Shattuck Chamber Membership Application

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This is the Membership Application for individuals, organizations and businesses that would like to be a part the Shattuck Chamber of Commerce. Thank you in advance for your contribution and for investing in the Shattuck Community! You are making a difference and it is appreciated!

Email *

Business Name *

Representative Name *

Representative Title *

Physical Address *

Mailing Address *

Website

Approx. how many employees do you have? *

Do you have a Facebook page for your business? *

Yes

Business Phone Number *

Cell Phone Number *

Choose your Membership Level *

Silver - $35.00/month or $420.00/year

Gold - $50.00/month or $600.00/year

Platinum - $1,500.00/year

PREMIER MEMBER - $2,000.00 and higher/year

Non-Profit - $150.00/year

Sr. Citizens - $75.00/year

Individual - $100.00/year

Requesting Complimentary Membership

Multiple Business Members Discount - inquire within

Payment Preference

Pay in Full

Monthly payments *small convenience fee

N/A

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