Membership Application

Date:

The table is provided to help Chamber members determine their fair and equitable investment in the development program of the Palacios Chamber of Commerce. Consideration has been given to the economic stake of members in Palacios’ growth in order to arrive at the business-like solution to a chronic problem.

Name of Firm/Organization

Owner(s)

Mailing Address

Phone Fax

E-mail Address

Business Website

Name of voting member

Total Employees

Please use the chart to determine your membership dues:

Business members – owns/manages a business or is self employed

Range 1 (0-2 Employees) $75 Range 2 (3-5 Employees) $100

Range 3 (6-20 Employees) $125 Range 4 (21-50 Employees) $200

Range 5 (51 and more) $300

Nonprofit Organizations $30 Individual Members $30

(No business relations)

PLEASE RETURN THIS APPLICATION TO THE CHAMBER OF COMMERCE

After your initial application is made, you will be billed annually in October. If there is a change in your range or classifications status, please contact the Chamber Office.

IF YOU ARE INTERESTED IN A 1 PAGE ON-LINE BROCHURE, PLEASE CONTACT THE CHAMBER FOR A PRICE AND FOR FURTHER INFORMATION.

Website picture of your business: $15.00/year per picture YES NO

AMOUNT ENCLOSED:

Signature