Membership Application for 2018

Myrtle Creek~Tri City Area Chamber of Commerce
P.O. Box 31
Myrtle Creek OR 97457

Membership Year is January 1, 2018 thru December 31, 2018.
Fees due by March 31, 2018

Please complete the requested information and return form with payment.
Accurate information is essential to help us promote your business.
Direct any questions to Chamber Secretary Ted Romas, 541-860-5846.

Business Name:(1)


Street Address:

Mailing Address:

Phone Number:

Fax Number:

  Number of employees: _______
(1)Note: All active members will be listed in Member Directory, however, full payment must be received by
  February 15, 2018 in order to include your business as a 2018 Chamber member in printed brochures, mailings and
  other promotional materials. Otherwise, the membership fee must be received by March 31, 2018 to continue to
  receive all other benefits of membership. After March 31st, dues are prorated by month of application.
(2)*FREE for 2018: As a FREE benefit of Chamber membership, the Chamber website at will   provide a link to your business website in the Member Directory.

Annual Membership Dues
______Private Individual
______1 to 5 Employees
______6 to 14 Employees
______15 to 24 Employees
______25+ Employees
_____Check here to have your Business Website Address linked to , as a FREE benefit of Chamber membership.

New members are welcome to join any time. Dues are prorated by month after March 31st Formula: Divide Annual Dues (see above) by 12, then multiply by FULL calendar months remaining in year, then round off to lowest dollar amount.
Payment Enclosed:   Amount: $_________________  Check # ____________   Date: ____________________

Cash Received (Do not mail cash): Amount:  $_______________  Date:_____________  By: ___________________________