Organization and Membership

Membership Enrollment Application

 

Company Name

Company Street Address


City, State and Zip

,

Telephone

Fax

Mailing Address
(if other than above)



,

Billing Address
(if other than above)



,

Section II

Type of Business

No Years in Business

No of Employees

Other Locations (3)

1.
2.
3.

Parent Company and Address
(if applicable)



,


A purchase order is required by my company to do business with the Greater Garder Chamber of Commerce.

If checked, please indicate below the appropriate process for our records, including the contact department & person responsible for the issuance of purchase order numbers:

Section III

In order for us to communicate effectively with our members and to eliminate waste in mailings, etc., we ask that you consider who in your organization you would like to receive information on our programs, services & networking opportunities. The Main Representative should be the CEO/manager/owner/operator, followed by others:

Main Representative
(Name, Title, Ext.)

Additional Representatives (5)
(Name, Title, Ext.)





Section IV

Your membership to the Greater Gardner Chamber of Commerce becomes effective with the completion of this application and full payment of your annual investment as defined by our Membership Investment Schedule. Your renewal will be automatically invoiced on an annual basis unless advised otherwise by a representative of your organization. The Board of Directors vote monthly to accept all members upon recommendation of the Membership Services Coordinator & upon approval of the President & CEO.

Name of Person Completing Form

Date of Application

Sponsor

Membership Investment

Member Plus+

Please print and complete, then mail or fax this form to:

Greater Gardner Chamber Of Commerce
210 Main Street, Gardner Ma 01440
Phone: 978-632-1780
Fax: 978-630-1767