Shoals Chamber of Commerce

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Your Investment
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Business Information:
Business Name:
Street Address:		Zip:
Mailing Address:		City:
State:		Zip:
Telephone:		Fax:
E-Mail Address:		Website:

Key Employees & Titles
CEO/President:		Vice President:
Human Resources:		Finance:
Branch Managers:
Assistant Managers
Sales/Marketing:		Purchasing:
Other:		Other:
Other:		Other:
Additional Locations:
Person to receive annual dues invoice:
Average number of full-time employees of your company in the Shoals:
Date:
Name of Sponsor:
Annual Investment $:		Please compute investment based on Investment Schedule
Next Billing Date:

Being in agreement with the policies and goals of the Shoals Chamber of Commerce, I agree to invest the above amount in the Chamber. I understand that this investment is due with this application and that subsequent investments for the membership dues portion will be payable annually. The Chamber may depend on my annual investment until I terminate or modify this agreement in writing.
Signed:		Title:
Date:
Card Type:		Card Number:
Name on card:		Expiration Date:
List One Additional Name for each $125 Investment above $225 to a maximum of 20 members
1.		2.
3.		4.
5.		6.
7.		8.
9.		10.
Number of years established in the Shoals:
What subsidiaries do you own?
Is your company listed by any other name(s)?
Are you a subsidiary of another company?
Please give a name and address of parent company:
Business Classification: (Use Yellow Pages category to indicate type of business)

What made you decide to join the Chamber?
Networking opportunities		Learning ways to improve my business
Having a stronger voice in government		Visibility in the business community
Civic duty
Other - Specify:

Please send me more information on:
CEO Roundtable		Small Business Seminars
Economic Data		Government Affairs Programs
Publications-Newsletter		Leadership Training
Advertising/Inserts Inside Publications		Membership Directory Advertising

The following are exclusive Chamber Member opportunities (Check those with which you wish to be involved)
Chamber Net (Long Distance Discount)
Member-to-Member Discount Program

What are other ways the Chamber can assist your business?

What are your expectations of the Chamber?

Please indicate if there is a committee, to which you or others in your company would like to join:
Air Services		Education
Member Services		Youth Leadership
Legislative Affairs		Leadership Development
Ambassadors		Arts Means Business
Local Issues		Business & Industry Services
Marketing/Communications