Membership Form

NORRIDGEWOCK AREA CHAMBER OF COMMERCE
PO Box 184
Norridgewock, ME 04957
www.norridgewockchamber.com
norridgewockareachamber@gmail.com

President Bob Gilcott @ (207) 634-2594 * Vice President Jeff McGown @ (207) 634-5200  * Secretary Sylvia Miller @ (207) 634-3748 * Treasurer Brenda Morgan @ (207) 634-2917

– Incorporated 1971 –

Membership Form

Individual / Business Name: ___________________________________________

Owner / Representative Name: _______________________________________

Business Description: __________________________________________________

Business Mailing Address: _____________________________________________ _______________________________________________________________________

Physical Address (if different): _________________________________________

Business Phone: ___________________ Cell Phone: __________________

Individual / Business Email: ___________________________________________

Business Website: ______________________________________________________

                                         Tell us a little bit about yourself.

What is your business profile? ______________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________

Membership fees:
______$10.00 for Individual
______$10.00 for Civic / Non Profit / Education
______$25.00 for Small Business (<11 full-time employees)
______$35.00 for large business or Multi-Business
Date: ___________  Check #: ______________   Cash Received: $____________

The work of the Chamber is financed by the investment of members who support it.  The majority of the income of the Chamber comes from des. THANK YOU!

Revised 10/2017