Date:
The undersigned makes application for membership or renewal of membership and agrees to pay the annual dues as indicated on the schedule of Dues included in this form as set by the Board of Directors of the Bridgeton Area Chamber of Commerce of Bridgeton, NJ. This agreement replaces all membership and sustaining subscriptions of prior date. The right is reserved to revise or cancel by written notice prior to the close of any Annual Period. Any individual or business entity may be eligible for membership in the Chamber. A business entity eligible for membership is entitled to one vote on all chamber matters no matter how many employees are in attendance from said business entity at any chamber function. Membership in the Chamber is construed as a representation by the applicant of his bona fide interest in the program and purposes of the Chamber and the member's agreement to abide by the provisions of the by-laws, rules and regulations properly adopted by the Board of Directors. Any membership may be terminated by the Board of Directors for non-payment of the membership fee or other financial obligation due and owing by a member to the Chamber or for conduct or activities detrimental to the best interest of the Chamber. Termination procedures are explained in the Chamber By-laws. A Copy of By-laws will be provided upon request.
Business/ Organization / Individual:
Address:
City: State: Zip Code:
Point of Contact: Title:
Telephone Area Code: - Ext. Fax: -
Email:
Web:
Type of Business:
Brief description of Products and Services:
Number of Employees: Count 1 full time for 2 part time: __________________ Individual $125.00 1 - 5 $150.00 6 - 25 $180.00 26 - 50 $210.00 51 - 100 $275.00 101 - 150 $330.00 151 - 200 $400.00 201 - 250 $450.00 251 - 300 $500.00 Over 300 $625.00 All Banks $275.00
Credit Card Type: __________________ Visa Master Card Discover Expiration Date
3 digit Security code on the back of your card: Zip Code of Card Billing Address:
Credit Card Number:
Name as it appears on the credit card:
Who Referred You to the Chamber
Annual Membership Dues as indicated in the box above are payable in advance. Please mail or deliver your check to the chamber office to complete this membership application.
Signature:_____________________
Please print this application. Provide signature indicating your acceptance of the terms and conditions of this membership.
Return this signed form with your check to: The Bridgeton Area Chamber of Commerce, PO Box 1063, Bridgeton, NJ 08302
Please review your information for accuracy before clicking the submit button and print it for your records.
