RATHDRUM CHAMBER OF COMMERCE
8184 Main Street
Rathdrum, Idaho 83858
MEMBERSHIP APPLICATION
Name of Business, Individual, or Organization:
__________________________________________________________________
Mailing Address:_____________________________________________________
Street Address: _____________________________________________________
City:___________________________State:______Zip Code: ________________
Telephone: ___________________________Fax:__________________________
E-Mail:____________________________Website:_________________________
Representative's Name: ____________________________________________________
Title: ______________________________________________________________
Type of Business / Service: _________________________________________________
Number of Employees:_________________
ANNUAL MEMBERSHIP DUES
Student..............................................................................$15.00
Non-Business Individual, Non-Profit Organizations............$30.00
Business Person, Sole Proprietorships...............................$85.00
Corporation, Small (under 20 employees)..........................$150.00
Corporation, Large Local (over 20 employees)...................$300.00
Corporation, Large Regional (over 20 employees).............$500.00
Payment Enclosed: $_______________ Referred by:_____________________________________
Please make check payable to the Rathdrum Area Chamber of Commerce
Authorized Signature:___________________________ Date:____________________________________
I would be interested in serving on the following Committee(s):
( ) Membership Relations ( ) Economic Development
( ) Community Events ( ) Fund Raising
( ) Legislative Activities |
