History Well Preserved - Woodstock IL Chamber of Commerce

Woodstock Chamber Membership Application

fields marked * are required

Business Name *

Parent Company

Mailing/Billing Address *

City *

State *

Zip Code *

Phone *

Fax

Location Address (if different)

City

Contact Person *

State

E-mail *

Zip

Website

Year Established *

Recommended By

Description of Business (for publicity purposes)

Are you interested in committee work?

Yes No

Employee Information
Dues are based on total employees. Please enter the number of employees at your company in the boxes below.
Full Time Employees *
Part Time Employees *

Select the appropriate type of membership below. The total amount of dues will update based on the items selected.

0 Full Time Employees 0 Part Time Employees		Home-based Business	$166.00
Associate Member (of a current member)	$122.00	Non-Profit (5 or fewer paid employees)	$122.00
Individuals (no business)	$122.00	Church	$122.00
President's Club Membership $1000.00 (in addition to annual dues)		Chairman''s Club Membership $5000.00 (in addition to annual dues)

Total Annual Dues: $0.00

Dues Payment *

Annual Semi-Annual

Total Due Now: $0.00

Pay By Check

click button to print form and send with check to:
Woodstock Chamber of Commerce and Industry
136 Cass Street
Woodstock, IL 60098

Pay Securely via Credit Card (Visa or MasterCard)
You must fill in all information in this portion of the form, if you are using a credit card.

Card Number

Expiration Date (00/00)

Name on Card

Address on Card

City, State Zip