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ONLINE MEMBERSHIP FORM

You may complete this form, then send to us online
by selecting the SUBMIT button below.

You may also download this application as a pdf file, print, complete, and send to us.

The form may be faxed to 660-646-3309 or mailed to P.O. Box 407.
Our office is located in the Commerce Center at 514 Washington.

MEMBERSHIP APPLICATION 2008 - Download as PDF

You may submit your membership by completing this online application, selecting the proper membership investment category, and clicking SUBMIT. Then, mail your check via U.S. mail to the address shown at the bottom of this form. We now accept VISA and MasterCard payments.

Business/Organization Name:

Briefly describe your business services and/or products: Example: Friends - Clothing, Jewelry, Home Decor. This information will be added to your business listing within the directory on this web site.

Please indicate the main reasons you are joining the Chamber (check all that apply)

Increase Revenue  Increase Visibility and credibility for your business

Listing in The Chillicothe Insider, a resource and reference guide given to every member
and newcomers to the community

Have a voice in local, state & federal government on business issues

Contacts, Contacts, Contacts!  Be featured on the Chamber Web Site

Give back to the community   Quality seminars offered locally

Ribbon Cutting Ceremonies for new and expanding Chamber member businesses

Opportunities to "make something happen" through involvement on committees

Contact Person:

Physical Address:

City / State / Zip://

Billing Address (if different):

Phone:

Fax:

E-mail Address:

Web Site:

Your Chamber membership extends to every member of your staff. While you're busy running your business, members of your staff can attend Chamber functions and bring the knowledge and contacts they gain back to you. To ensure your staff is aware of Chamber happenings, you may add key representatives to our mailing list below. Please keep us updated as contact information changes.

Additional Representative (Optional):
Email Address:
Telephone: Fax:

Additional Representative (Optional):
Email Address:
Telephone: Fax:

To add additional personnel or to make changes to our contact list, email office@chillicothemo.com.

The year your business was established:

Number of Full-Time Employees (including yourself):
Number of Part-Time Employees:

Contact me for Chamber Luncheon Reservations and Announcements by:

I would like to be notified in case of a Merchant Alert: By Email By Fax
(suspicious or fraudulent activity reported to the Chamber from the Chillicothe Police or Sheriff's Department, or the Livingston County Prosecuting Attorney)

I would like to sign up as a Chamber Ambassador: Yes No

Become involved to get the most from your Chamber membership. You will be notified about upcoming events and activities and be given an opportunity to serve as a committee member or volunteer.

I understand that by providing the fax number and/or email address above for the business or organization represented in this application, I am authorized to and hereby consent for our business to receive faxes and/or emails from the Chillicothe Area Chamber of Commerce.

Signature:

 Comments, Questions, Suggestions:

Select your membership investment category below, then...

Mail your check to:
Chillicothe Area Chamber of Commerce
P O Box 407
Chillicothe, MO 64601
Or, we will invoice you.
Questions? Call 660-646-4050

Chillicothe Area Chamber of Commerce
2008 Membership Investment Categories
(Based on number of FTE employees: 2 part-time = 1 full time)
View our current membership pricing structure as a PDF.

Accounting/Bookkeeping | Agri-Business | Auto Dealer | Construction/Contractor
Educational InstitutionEldercare | Financial | Government | Health Care
Individual | Insurance/Real Estate | Investment | Legal | Loan Services
Manufacturer | Media Newspaper/Radio | Non-Profit | Motel/Rental Properties
Professional Services | Restaurant | Retailers/Services | Utilities | Wholesaler/Distributor

Membership Investment Levels (please select one):

Accounting/Bookkeeping
1 *Principal: $203.00 2 Principals: $295.00 3+ Principals: $378.00

Agri-Business
0-5 Employees: $203.00 6-10 Emp.: $295.00 11+ Emp.: $404.00

Auto Dealer
0-5 Employees: $203.00 6-10 Emp.: $295.00 11+ Employees: $404.00

Construction/Contractor
0-5 Employees: $203.00 6-10 Emp.: $295.00 11+ Emp.: $404.00

Educational Institution:
Public School: $263.00 Parochial School: $148.00 Undergraduate: $263.00

Eldercare:
0-15 Employees: $203.00 16-30 Employees: $295.00 31-49 Employees: $404.00
50-70 Employees: $640.00 71-100 Employees: $810.00 101+ Employees: $1094.00
Non-Profit: $203.00

Financial: $929.00

Government:  $203.00

Health Care
0-15 Employees: $203.00 16-30 Employees: $295.00 31-49 Employees: $404.00
50-70 Employees: $640.00 71-100 Employees: $810.00 101+ Employees: $1094.00

Individual: $94.00 (with no business affiliations)

Insurance/Real Estate
1 *Principal: $203.00 2 Principals: $295.00 3+ Principals: $404.00

Investment $263.00

Legal
1 *Principal: $295.00 2 Principals: $404.00 3+ Principals: $526.00

Loan Services: $263.00

Manufacturer
0-10 Emp.: $295.00 11-25 Emp.: $404.00 26-70 Emp.: $640.00
71-100 Emp.: $810.00 101+ Emp.: $929.00

Media (Newspaper/Radio)
0-5 Employees: $203.00 6-15 Emp.: $295.00 16+ Emp.: $404.00

Motel/Rental Properties
1-8 Rooms: $203.00 9-20 Rooms: $295.00 21+ Rooms: $404.00

Non-Profit: $94.00

Professional Services
Med/Prof/Phys & Surgeon/Opt/Dent/Vet
1 *Principal: $295.00 2 Principals: $404.00 3+ Principals: $526.00

Restaurant
0-5 Employees: $203.00 6-15 Emp.: $295.00 16+ Emp.: $404.00

Retailers/Services
0-5 Employees: $203.00 6-15 Emp.: $295.00 16-25 Emp.: $404.00
26-49 Emp.: $526.00 50-80 Emp.: $640 81-124 Emp.: $810
125-199 Emp.: $853 200-249 Emp.: $929 250+ Emp.: $1094

Utilities
Non-Profit: $465.00 Public: $640.00 For Profit: $810.00

Wholesaler/Distributor
0-10 Emp.: $295.00 11-25 Emp.: $404.00 26-70 Emp.: $640
71-100 Employees $810 101+ Employees: $929
*Principal (Practicing Professional)

You may submit your information here online, then...

Mail your check to:
Chillicothe Area Chamber of Commerce
P O Box 407
Chillicothe, MO  64601

Or, we will invoice you.

Note: Membership dues are requested by January 1, 2008.
A late fee of $10 will be charged for dues received after February 1.
Members who have not paid membership dues by March 1 will be dropped.
A $25 reinstatement fee will be charged to restore membership for 2008.

Questions?  Call 660-646-4050

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