Creating an environment that supports and attracts business

(800) 565-3793 (403) 845-5450

SERVING

Caroline
Condor
Leslieville
Nordegg
Sunchild/
O'Chiese

CREDIBLE
INFLUENTIAL
RESPECTED
MEMBER
DRIVEN

Rocky Mountain House & District Chamber of Commerce

MEMBERSHIP APPLICATION

(All fields marked with * are required.)

MEMBERSHIP APPLICATION

(All fields marked with * are required.)

Public Information

(This Information Will be Published on Chamber Website)

Business Name *
Address *
City * Province *
Postal Code *
Description of your business *
Product/Service Tags: *

Business Categories:

Primary *

Secondary

Suggestion:

Contact Person *
Phone *
Email *
Fax
Website
I give permission to publish the above information on the Chamber website.

I agree the information above will be published. Sign here:

Private Information

(This information will NOT be published on Chamber Website)

Business Owner *
Phone *
Owner Email *
Fax
Name of Voting Representative *
First of Multiple Businesses
Yes No
(If this is the second or subsequent business with the same owner joining the Chamber, record the name of the business that is already a member. Your membership fee will be reduced by 50% on your invoice.)

Choose your 2011 Membership Rate below:

		$
	1-2 Employees	88.20
	3-5 Employees	104.74
	6-10 Employees	170.89
	11-15 Employees	198.45

		$
	16-20 Employees	253.58
	20+ Employees	363.83
	Individual/Farmers	73.50
	Society (non-profit)	73.50

(Prices include GST)

Business Categories:

Please choose a primary category that best defines your business. You can also choose a secondary category if needed.

Your business will be listed on the Chamber website under the categories you select.

If you believe you need a new category to describe your business, please suggest it.

Product/Service Tags:

Include a complete list of products and services you provide, separated by commas. This is used by the website search tool when visitors search for products/services.

Multiple Businesses

For each additional business the membership fee will be reduced by 50%. Each business will still have one vote.

Instructions

You can submit this application electronically or print it.

Electronic Submission

After filling out all the fields on the form, press the Submit button. Your invoice will appear on your screen. You can then print one for your records and one to send with your payment.

Manual Submission

Press the Print button to print a blank copy of the application form, or fill in the form on-screen and then press Print.

Payment

Both the printed application form and the invoice contain an area for you to record your payment information.

If you are paying by cheque, please mail a copy of the invoice with payment. If you are paying by credit card, you can fill in the credit information and fax it.

Payment

Payment Amount
$
M/C
Visa
Cheque
Visa or M/C #
Expires
/
Print Name
Signature
Date (YY/MM/DD)

Mail payment to:
Box 1346
Rocky Mountain House, AB T4T1B1
If credit card, fax to
(403) 845-7764

Please enter the code shown in the image below. (It proves you're not a robot.)

MEMBERSHIP APPLICATION

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