Application for Membership

Business Name

Your Name (required)

Contact Phone (required)

Business Physical Address

Mailing Address

Your Email (required)

Your Web site Address

Your Facebook Address

Type of Membership

Are you registering as a business, government, non-profit, or individual entity? (required)
NOTE: We define large businesses as those companies or non-profits employing more than 50 people.
Business - $50Non-profit - $10Individual - $10Government - $100Large Business/Non-profit - $100

Please input the cost of your membership type into the box below to signify you understand the cost of joining the Eminence Chamber of Commerce. (required)

Standard Listings

Standard listings are FREE with your Chamber membership. Please select the categories (check all that apply) your business should be listed in.
CampgroundsLodgingBusiness ServicesCanoeingChurchesDiningGovernmentHealth CareHorseback RidingIndustrialNon-profitRecreationRetreatsShopping

Enhanced Listings

Would you like any enhanced listings (Enhanced listings include: image, description, and link to your Web site or Facebook page) on the Chamber's Web site?
($50 fee for the each category)
YesNo

If yes, please select your primary business category. Remember the primary category is $50.
CampgroundsLodgingBusiness ServicesCanoeingChurchesDiningGovernmentHealth CareHorseback RidingIndustrialNon-profitRecreationRetreatsShopping

Would you like any additional ($50 each) enhanced listings? If yes, check all that apply.
CampgroundsLodgingBusiness ServicesCanoeingChurchesDiningGovernmentHealth CareHorseback RidingIndustrialNon-profitRecreationRetreatsShopping

What is the total cost of your enhanced listings? ($50 for each listing)
NOTE:
By inserting your value in this box, you are certifying that you understand the additional charges.

Chamber Brochure Listing

Are you interested in being listed in the Chamber's brochure? ($100 fee)
YesNo

If yes, please insert $100 into the box below to certify that you understand the additional charge.

Business Description

If you are interested in being featured in our brochure or having an enhanced listing on our Web site, please include a short description for your business.
NOTE: If you wish your Web site to be included in the brochure you will want to include it in your description.
NOTE: If you had a listing last year and don't want to make any changes, please input "no changes" into the field below.

Authorization & Understanding

I certify that I understand the costs and benefits associated with Chamber membership.
YesNo

To demonstrate that you understand the total costs associated with joining the Chamber of Commerce, please add up the total value of the red fields above, and place the total in the box below. (required)