APPLICATION FOR MEMBERSHIP OR RENEWAL 2008

Business Name: __________________________________________________________

Main Contact: ____________________________ Title: ________________________

Mailing Address: ________________________________________________________

Street Address: __________________________________________________________

Brief Description of Business ________________________________________________________

_____________________________________________________________________________________

Phone # ______________________ Fax # _______________________________

E-Mail ______________________ Website ____________________________

 Check here if you DO NOT want this information to be listed in the website directory

*Membership dues are not tax deductible as a charitable contribution for federal income tax purposes; however, they are deductible for most members as an ordinary and necessary business expense.

Annual Dues Schedule

#Employees Yearly Dues

A. 1 to 2 $ 40.00

B. 3 to 5 $ 60.00

C. 6 to 10 $125.00

D. 11 to 25 $200.00

E. 26 to 100 $250.00

F. Over 100 $350.00

Total Due

$___________

*Dues or non-for-profit membership groups is $40.00

Signature: ___________________________________________________ Date: _________________

THANKS FOR YOUR SUPPORT!

Please return by March 31^st so we can update our website.

Please return this form to: American Falls Chamber

PO Box 207

American Falls, ID 83211