| Membership Type:* |
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| Contact Type:* |
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MEMBERSHIP LISTING
Business Name:* |
Type "Supporter" if not a business. |
| Physical Address: * |
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Check this box if you have a home-based business
and do NOT want the physical address published. |
Mailing Address
(if different than above): * |
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| City ST ZIP Code: |
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Date Business
Started/Purchased:* |
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| Contact Name: * |
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| Office Phone: * |
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| Toll Free No:* |
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| Fax No:* |
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| Contact email:* |
double-check address |
| Website URL:* |
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| Preferred method of contact from Chamber:* |
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Check this box if you are interested in Co-op advertising opportunities offered through the Chamber. |
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Check this box if you are interested in having a Member Web Page on the Chamber's website for a low annual fee. |
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Chamber-hosted Event Sponsorship Options. Check all that apply.
I am interested in sponsoring...
Valentine's Day Gift Basket |
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Yates Center Day |
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Woodson County Fall Festival |
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Merchant Holiday Open House / Soup Supper |
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Adopt-a-Child (Christmas) |
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Other opportunities, please notify me |
| Comments: |
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| Enter the security code:* |
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