APPLICATION FOR MEMBERSHIP
Firm Name:
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Street Address:
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P.O. Box:
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City/State:
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Zip:
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Telephone:
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Fax:
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Email Address:
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Website Url:
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Facebook Url:
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# Full Time Employees:
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# Part Time Employees:
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Annual Dues Amount:
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BUSINESS OWNER/CEO
Name:
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Title:
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Telephone (include Ext):
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Fax:
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Email Address:
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OTHERS TO WHOM CHAMBER MAIL SHOULD BE DIRECTED #1
Name:
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Title:
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Telephone (include Ext):
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Fax:
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Email Address:
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OTHERS TO WHOM CHAMBER MAIL SHOULD BE DIRECTED #2
Name:
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Title:
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Telephone (include Ext):
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Fax:
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GIVE A BRIEF DESCRIPTION (15 WORDS OR LESS) OF YOUR BUSINESS FOR YOUR FREE LISTING IN THE MEMBERSHIP DIRECTORY.
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IN WHAT CATEGORIES SHOULD YOU OR YOUR BUSINESS BE LISTED?
Use either the telephone book page listing or our category listing (www.marionareachamber.org/web_pages/IndexofBusinessCategories.pdf) as a guide. This is a free benefit of membership.
1)
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2)
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3)
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4)
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5)
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