Highland Area Chamber of Commerce
Express
Application
Firm Name:
________________________________
Business Address: ___________________________
City,
State & Zip: ___________________________
Telephone: ________________
Fax: ____________
Mailing Address (if different from above):
__________________________________________
City, State & Zip: ____________________________
Email Address:
______________________________
Web Page Address: __________________________
Service
Provided (retail sales, service, etc):
_________________________________________________________
_________________________________________________________
Owner(s)
Name: ______________________________
Contact Person for all mailings: ____________________
Membership
Annual Investment
Businesses:
0 - 3 employees
$110.00
4
- 9 employees
$160.00
10 - 15 employees
$185.00
16 - 20 employees
$225.00
21 - 49 employees
$300.00
50
or more employees
$325.00
Associates
$75.00
(Independent contractors who are under a
Business Member,
i.e., Realtor,
Beautician, etc.)
Individual Membership
$75.00
Clubs, Service & Charitable Organizations
$100.00
*Administrative Fee- One time only new member fee $25.00
TOTAL AMOUNT ENCLOSED
$ ________
I am interested in the following areas:
+ Legislative
+ Business & Promotion
+ Community Affairs + Membership
Services
+ Home
Business Marketing +
Economic Development
Referred
By: _______________________________
Mail this form and a check to:
Highland
Area Chamber of Commerce
P.O. Box. 455 - Highland Ca. 92346
