NAME_____________________________________________________________________________________________
MAILING
ADDRESS__________________________________________________________________________________
PHYSICAL
ADDRESS_________________________________________________________________________________
CITY__________________________________ST_______________ZIP__________________________________________
PHONE___________________FAX___________________EMAIL_____________________________________________
WEBSITE_______________________________________________________NUMBER
OF EMPLOYEES_________
OWNER/CONTACT
NAME_____________________________________________________________________________
TYPE
OF MERCHANDISE – SERVICE
OFFERED_______________________________________________________
PLEASE CHECK YOUR ANNUAL INVESTMENT
____BUSINESS,
CLUB, OR ORGANIZATION (1-20 EMPLOYEES)
$120.00
____BUSINESS,
CLUB, OR ORGANIZATION (21-30 EMPLOYEES)
$200.00
____BUSINESS,
CLUB OR ORGANIZATION (31-50 EMPLOYEES)
$300.00
____BUSINESS,
CLUB OR ORGANIZATION (51+ EMPLOYEES)
$500.00
____INDIVIDUAL
MEMBERSHIP
$ 25.00
____CHURCH
MEMBERSHIP & 501 C3 Organizations
$ 25.00
____SENIOR
CITIZEN (60 +)
$ 15.00
I
support the Winnsboro Area Chamber of Commerce and its program of work for the
welfare and benefit of this city. I
pledge a membership investment in the amount checked above, payable each year in
advance. I understand that this
contract automatically renews itself each year unless changed by written notice.
_______________________________________________________________________________________________
Signature
Title
Date
100 E Broadway
- Winnsboro, TX 75494 - 903-342-3666 - info@winnsboro.com