Membership Application

Your Name and Contact Information

Name or Company Name
Address
City
Zip/Postal Code
Telephone
Fax Number
Website Address
Contact Person
Contact Email

Membership Type

Business Membership
	Small Business - $90 semi-annually, $180 annually (One vote) (1 to 5 owners and employees)
	Medium Business - $120 semi-annually, $240 annually (Two votes) (6 to 24 owners and employees)
	Large Business - $150 semi-annually, $300 annually (Three votes) (25+ owners and employees)
	Non-profit Organizations/Churches - $60 annually (One vote)
Financial Institutions & Utilities
	All Financial Institutions and Utilities - $250 semi-annually, $500 annually (Four votes)

Agreement and Form Submission

Pledge
I hereby pledge myself, or firm represented, to pay the amount checked above to the Jacksboro Chamber of Commerce, until such time I may cancel my membership. I understand that if my dues are not paid within three months of the due date, my membership may be cancelled upon notification. By submitting this application you agree to the pledge above.
You will be billed each period that you have checked above or your acount may be drafted. Billing periods are January 1 and July 1 of every year.

Access Code:
*Enter the Access Code:

Events

12 July:

Indian Lecture Day (10:00 am)

26 July:

Guys and Gals Car Show (5:30 pm)

31 July:

SUMMERFEST (5:00 pm)

Copyright 2007 Jacksboro Chamber of Commerce. All rights reserved.
PO Box 606, Jacksboro, Texas 76458 • Tel: 940.567.2602

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