Dcoc Member Application Form - Dunnville Chamber Of Commerce

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231 Chestnut Street
Fax: 905-774-9281
Dunnville ON N1A 2H2
Email:
Phone: 905-774-3183
Website:
Member Application (
st
fees apply as of January 1
annually)
Business/Organization Name: ________________________________________________________________
Contact Name(s): __________________________________________________________________________
Address: _________________________________________________________________________________
City: ______________________________________ Prov: ___________ Postal Code: __________________
Phone: __________________________________ Toll Free Phone: __________________________________
Fax: ______________________________________ Cell Phone: ____________________________________
Email: ___________________________________________________________________________________
Website: ________________________________________________________________________________
Business Directory Categories - (Please circle all that apply):
Accommodation
Attraction
Automotive
Cakes/Candy/Catering
Campground Trailer Park
Club
Computer
Contractor
Entertainment
Financial
Funeral
Government
Healthcare/Beauty
Home Decorating
Individual
Insurance
Manufacturer
Media Services
Real Estate
Restaurant
Retail
Sports/Leisure
Other (Specify): ________________________________________
Membership Categories & Fees - (Please circle only one):
1 – 5 Employees
$125.00
(We do not collect or remit GST)
6 – 10 Employees
$160.00
11 – 25 Employees
$218.00
26 – 50 Employees
$235.00
50+ Employees
$343.00
Individuals (Not a business category)
$75.00
Non – Profit
$75.00
Membership fees include: your online presence: a description and pictures of your business, a link to your
website (if applicable), and all your event advertising needs.
COMPLETE THIS PART: Cheque is for $____________________
Signature: ___________________________________________________ Date: ______________________
PLEASE RETURN THIS FORM BY MAIL OR DROP IT OFF AT THE OFFICE WITH YOUR CHEQUE. WE WILL SEND YOU A
RECIEPT AS SOON AS POSSIBLE. INFORMATION CONTAINED ON THIS FORM WILL ONLY BE USED TO UPDATE OUR
MEMBERSHIP RECORDS. WE DO NOT ALLOW ACCESS OF OUR RECORDS TO EXTERNAL ORGANIZATIONS.

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