Boone County Chamber of Commerce  
 

BOONE COUNTY CHAMBER OF COMMERCE
2010 Membership Application

 
 

Payments by Check

  
Please complete form with current company information via text box, selecting all choice buttons or drop down box options! 
Required Field *
Company Name
Parent Company Name
Contact Person *
Title
Address
PO Box
City
State
Zip Code
Phone Number *
Fax Number
Email Address
Ability to Receive emailYes No
Website Address
Member Discount Cards Needed?
Sponsor Level MembershipsGold $1,500 Platinum $2,500 Chamber Partner $5,000
Event to SponsorHome Show (April) Golf Outing (June) Directors Election (Sept) Civic Banquet (Nov)
Civic Membership$100 Sponsor Members, Civic Organization, Not-for-Profit Organizations, and Individuals
General Memberships
Number of Employees
Current Dues Amount
Representative 1
Representative 1 email address
Representative 2
Representative 2 email address
Representative 3
Representative 3 email address
Representative 4
Representative 4 email address
Type of Business
Discription of Business
Your Name
Date
Verification* 

Please key in the verification code shown above.
This will help protect you in preventing spammers from running scripts that acquire email addresses.

  Note: Annual Billing occurs every January.
  Upon receipt of your dues and Chamber Board approval, your Chamber membership packet will be mailed.