MEMBERSHIP APPLICATION

Sign up for: Price

Number of employees:_____ $ __________
Additional Representative $ __________
Additional Representative $ __________
School, Charitable Organization $ __________
Retiree $ __________
Professional in Transition $ __________

Total: $ __________

name ____________________________________
additional reps name ____________________________________
company ____________________________________
address ____________________________________
city/state/zip ____________________________________
phone ____________________________________
fax ____________________________________
cell phone ____________________________________
email address ____________________________________
web address ____________________________________

We offer a cash referral bonus to members who bring us new members! Please tell us who shared the Greater Cool
Springs Chamber with you, so we can give the bonus to the correct person!
 MEMBERSHIP CATEGORIES
(based on full-time employees)
1 - 3 employees (1 rep) $300
4-10 employees (1 rep) $325
11-25 employees (1 rep) $375
26-40 employees (1 rep) $450
41-50 employees (2 reps) $500
51-75 employees (2 reps) $550
76-99 employees (2 reps) $600
100 -199 employees (3 reps) $725
200-299 employees (3 reps) $850
300 + employees (3 reps) $1,000
Additional Representatives $200
School, Charitable Organization $200
Retiree $100
Professional in Transition $100

method of payment: ______________

______________________ credit card #
_________ exp date
_________ code on back
_________ zip code
_____________________ signature

ared the Greater Cool

Name: ________________________________