2020 Membership Application

BUSINESS INFORMATION Business Name___________________________________________________________________________________ Contact Name ___________________________________________________________________________________ (Published**) Address_____________________________________________________________________________ City _________________________________________________________________ State __________ Zip ________ Telephone ( _______ ) _______ - __________ Fax ( _______ ) _______ - __________ Website _________________________________________________________________________________________ Email Address ___________________________________________________________________________________ Description of Business (30 words or less):  Description attached _________________________________________________________________________________________________ _________________________________________________________________________________________________ Number of Employees (part-timers 2 for 1): Full Time __________ Part Time __________ Were you referred by another member?  Yes  No Member Name _________________________________

Please let us know which member, so we can thank them! Members receive a $25 credit for each referral that joins.

MAILING ADDRESS  Same as above Address _________________________________________________________________________________________ City _________________________________________________________________ State _______ Zip ___________ Contact Preference:  Email  Phone  Mail Signature ____________________________________________________________ Date _____ / _____ / ________ Title/Position_____________________________________________________________________________________

SUBMISSION Please submit your application, business description and payment to: BARTLETT AREA CHAMBER OF COMMERCE 335 S. Main Street, Lower Level of BMO Harris Bank • Bartlett, IL 60103 Please include a one-time administrative fee of $20 | Contact the Chamber for additional payment options Payment  Check (enclosed) | Credit Card:  Visa  MasterCard  American Express Amount ____________________________ Expiration Date _____ / _____ / ________ Security code __________ Card Number ____________________________________________________________________________________ Card Billing Address ______________________________________________________________________________  Same as billing address  Same as mailing address