Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download DARKE COUNTY CHAMBER OF COMMERCE
Document related concepts
no text concepts found
Transcript
DARKE COUNTY CHAMBER OF COMMERCE Membership Application Company Name _______________________________________________________________________ Mailing Address _______________________________________________________________________ Business Address (if different) ____________________________________________________________ City, State, Zip Code ___________________________________________________________________ Phone: ___________________________ Fax Number: _______________________________________ E-Mail: __________________________________ Website: ___________________________________ Representative: ________________________________________________________________________ I wish to participate in the Chamber Gift Certificate Program _____________ Yes _______________ No I would like further information about these Member Benefit Programs: _____ Workers Compensation _____ Hearing Aid Supplies _____ Hospitalization _____ ECPA Vision Discount Plan _____ Promotional Mailings _____ RX Prescription Drug Plan _____ Superior Dental Plan _____ Educational Seminars & Webinars _____ Member 2 Member Discount Program _____ OSHA Training _____ Leadership Skills For The Workforce _____ Leadership Darke County _____ Darke County Teen Leadership _____ Workforce Development Training Seminars _____ Darke County Safety Council Would you prefer receiving Chamber communications via: _____E-mail _____Fax _____U.S. Postal Service The Chamber has an electronic Membership List on its website, www.darkecountyohio.com _____ I would like to establish a free link from the Chamber’s website to my website. My URL is:___________________________________________________________ _____ Yes, I prefer to receive targeted communications versus general membership communications: If yes, please help us “zero in” on your target communications needs: Type of Business:________________________________________(SIC code if known) _____Number of full-time employees _____Number of part-time _____________Annual Gross Sales Would you be interested in serving on any Chamber of Commerce Committee? _____________________________ I have enclosed my annual investment fee of $__________. I wish my investment charged to my Visa/MasterCard (circle one). Account # ____________________________ Expiration Date __________ Please bill me for my investment_____ “I understand that membership in the Darke County Chamber of Commerce constitutes my express invitation or permission for the Chamber to transmit by telephone facsimile machines to the number(s) I’ve provided above, email or written materials, including but not limited to those relating to property, goods, services, events, meetings or notices, and the availability thereof. I also understand that these will be published in the Chamber’s membership directories, excluding those I’ve checked in the following: _____Phone _____ Fax Number _____E-mail Address Signature ____________________________________ Date ________________
