Please provide the following contact information:

Contact Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
Website Address

Preferred Method of Delivery for Chamber Communications:

Email Fax Mail

DUES AND DONATIONS:

2008 Membership Dues $100

2008 Celebration of Lights Booster $40
2008 Holiday Bus Tour of Lights $25
2008 Fireworks Fund $25
      OR
Contact me during November for my Holiday Donations

Total Dues plus Voluntary Donations: $

I would prefer Chamber Meetings to be:

Evening
Lunch

I would consider sponsoring a Chamber "Social Hour" on meeting nights:

Yes
No