Membership Application Form
Choose appropriate category: Date: ____________________
Commercial (for profit business)
Employees 1-10 $245.00______ Institutional –UCM $220.00______
11-20
$290.00______ Non Profit $220.00______
21-40 $335.00______ Individual –Non Business $100.00______
41-60 $390.00______ Spouse
of Member $55.00______
61-100 $430.00______ Retired (over 65) $55.00 ______
101+ $475.00______ Dual
membership with
Holden
Chamber $55.00_______
Name:______________________________________________________________________________
Business/Organization:_________________________________________________________________
Position/Title:________________________________________________________________________
Mailing Address:______________________________________________________________________
Street Address:_______________________________________________________________________
Recommended by:____________________________________________________________________
Telephone:_______________________________ Fax
Number:_________________________
Email Address:_______________________________________________________________________
Preferred Method of contact:
Email US
Mail
(Circle One)
I wish to pay my membership fees: Annually Semi-Annually
(add $5 processing fee)
INTERNET
ACCESS
As a chamber member your business can be linked onto our Web
page, all you have to do is include your Web page address and WE WILL GET YOU
LINKED TO OUR WEB SITE.
Web Page Address:__________________________________________________________________
The Greater Warrensburg Chamber of Commerce and
660-747-3168
877-OLD-DRUM
Fax: 660-429-5490
E-mail:
Web Site: www.warrensburg.org