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MEMBERSHIP
APPLICATION
WILLARD
AREA CHAMBER OF COMMERCE
16 MYRTLE
AVENUE
P. O. Box 73
Willard, Ohio 44890
(419) 935-1888
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Date ______________________
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| Business Name |
____________________________________________________ |
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| Contact Person |
____________________________________________________ |
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| Address |
____________________________________________________ |
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| City ________________________ |
State _______________ |
Zip ________________ |
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| Phone ___________________ |
Fax ___________________ |
Cell __________________ |
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| Email _____________________________ |
Website _____________________________ |
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Type of Business by Category
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I
Financial Institution
$175 + $5/Mill Local Dep
$2.50/Mill over 20 Mill
$ ____________ |
III
Retail & Service
$85+$2/Employee
$1/Emp over 50
$ ____________ |
V
Insurance, Real Estate, Media
Professional, Broker
$120+$2/Emp+$10/partner
$75 for 1 person operation
$ ____________ |
VII
Associate/Individual
$25 Flat Fee
$ ____________ |
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II
Industry, Wholesalers
Transportation
$120+$1/Emp
$0.50/Emp over 50
$ ____________ |
IV
Utilities
$175+$2/Emp
$1/Emp over 50
$ ____________ |
VI
Non-profit Org
$50 Flat Fee
$ ____________ |
VIII
Honorary
No Charge
$ ____________ |
IX
Agri Business
$110 Flat Fee
$ ____________ |
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Note
$400 is the maximum for any member, $25
added for each multiple listing
Number of Employees and Product/Service
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| Full Time
Employees _____________ |
Product/Service ____________________________ |
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| Applicants Signature
__________________________________________________________ |