2012 Membership Application
To apply for membership in the Swanton Area Chamber of Commerce or to renew your membership, complete both sides of this form. Please type or neatly print.
Company Information Please complete fully
Full Company Name_____________________________________________ Year Est. ________
Street Address __________________________________________ Suite # _________________
City ______________________________________ State ______________ ZIP _____________
Mailing Address (if different) ________________________________________________________
City ______________________________________ State ______________ ZIP _____________
Telephone No. ______________________________ Fax No. ____________________________
E-mail address __________________________________ Web Site _______________________
Main Representative (Mr. Mrs. Ms.) ________________________________________________
Title ___________________________________________________________________________
No. of Full-time Employees _________________ No. of Part -time Employees _______________
Membership Directory Listings
You may choose the listings from those on the back of this page. If you would like your business listed under additional categories that are not listed, please list them below.
Payment Information
Use the investment schedule on the back of this form to calculate your dues payment. Please make checks payable to the Swanton Area Chamber of Commerce.
Dues payment $________ Mail Payment to:
Swanton Area Chamber of Commerce
100 Broadway Street
Swanton, OH 43558
Dues to the Swanton Area Chamber of Commerce are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense. I understand that Chamber membership does not guarantee acceptance into any Swanton Area Chamber of Commerce benefit program. I further understand that the Chamber has a no refund policy. All applications are subject to approval by the Swanton Area Chamber of Commerce board of directors.
| Business and Industry |
|
|
| 1-5 employees |
|
$150.00 |
| 6-10 employees |
|
$225.00 |
| 11-25 employees |
|
$290.00 |
| 26 or more employees |
|
$440.00 |
| |
|
|
| Bank, Credit Unions, Utilities, Hospitals |
$440.00 |
| |
|
|
| Associate |
|
$90.00 |
| Non-business status - churches, |
|
| service clubs and organizations, 501c 3 charities, |
|
| public officials |
|
|
| |
|
|
| Home Based Business |
|
$90.00 |
| Business based in the home with no employees |
|
| |
|
|
| Individual/Retiree |
|
$50.00 |
| If not eligible for any other category |
|
|
| |
|
|
| Note: 2 part time equals |
|
|
| 1 full time |
|
|
| |
|
| Membership Directory Listings Check or circle all that apply |
| Accountants & Investment Brokers |
Funeral Homes |
Optometrist |
| Attorneys |
Food Store |
Organizations |
| Automotive |
Gift/Jewelry |
Pharmacy |
| Body Shop |
Hair/Beauty |
Photography |
| Books |
Hardware |
Plumbing/Heating/Electrical |
| Catering |
Home Furnishings/TV/Appliance |
Printing |
| Chiropractic |
Housing/Construction |
Public Officials/Government |
| Church |
Individual |
Real Estate Agents |
| Clothing/Shoes |
Industrial |
Recreation |
| Computers |
Insurance |
Restaurants |
| Communications |
Internet Providers |
Schools |
| Dentist |
Janitorial |
Tax Service |
| Dry Cleaner |
Lodging |
Travel Agent |
| Employment Agencies |
Lumber company |
Utilities |
| Entertainment |
Media |
Veterinarian |
| Finance |
Medical/Hospital |
Video Store |
| Fitness Center |
Music |
Water Treatment |
| Florists |
Office Services |
Other:__________________ |
| |
|
________________________ |
