Wednesday, March 10, 2010
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Greater Brookfield Chamber of Commerce
Member Application

Click here for a printable version

 * Indicates required fields.
Phone Number: *
* Company Name
* Chamber Representative
* Address
* City
* Zip Code
* Telephone Number
FAX Number
* E-Mail
Web Site
* Membership Category
Additional Business Category
2010 12-Month Annual Investment (Based on number of full time employees, check your FTE). Please Include $35.00 for a one-time application fee and $25 per additional business category.
Category 1: 1-5 $325
Category 2: 6-10 $355
Category 3: 11-25 $490
Category 4: 26-75 $700
Category 5: 76-125 $815
Category 6: 126-200 $995
Category 7: 201-299 $1190
Category 8: 300+ $1410
Payment Details (Please Check) Make check payable to the Brookfield Chamber of Commerce and remit with application to:1305 N. Barker Rd., Brookfield, WI 53045 (Dues may be tax deductible as a business expense.) If Credit card is checked please call in the credit card number.*
Cash
Check
Credit Card (Visa or Master Card)
SPECIAL OFFER for new members at time of application - Purchase the current member mailing list and receive a discounted rate of $35. One-time use only and printed on white labels -- available for pick up at Chamber office.
Yes, I would like to purchase the mailing list.
 
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