Prescott Nevada County Chamber of Commerce
Classification__________________________ Date____________________ Name___________________________ Title_________________________ Business Mailing Address: P.O. Box_______________________ Street_________________________ City__________________________ State______ Zip_________________ Telephone________________________ Fax_________________________ Email Address:_________________________________________________ I hereby subscribe to membership in the Prescott- Nevada County Chamber of Commerce and promise to pay annual dues in the amount of $________________ (payable in advance) as follows: ______ Annually I hereby agree that this membership is to continue in force until resignation is submitted by me in writing to the Nevada County Chamber of Commerce Office. ________________________ ________________________ Prescott-Nevada County Only one person from your business can be designated to vote in any of the Chamber elections. Who would you like that person to be? Name:______________________________________ Is there anyone associated with your business who should receive all mailings? Who would you like that person to be? Name:_________________________________________ Is there anyone associated with your business who would like to serve on any Committee or would like to become involved in any of the various Chamber activities? Please List Names: In what other areas do you feel the Chamber should become involved? _________________________ |