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Company Name: |
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Street Address: |
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Mailing Address |
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City, State, Zip+4: |
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Phone: |
Fax:
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E-Mail Address: |
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Web Site Address: |
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Owner(s) Name(s) and
Title(s): |
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Contact(s) Name(s)/Title(s)
to be used for the Members
Directory: |
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Name(s) of any person(s) to
receive mailings: |
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Full Description of Business
and SIC (Standard Industrial
Classification), if known: |
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Business Classification
(check all that apply): |
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Agriculture (includes
landscapers, veterinary
services) |
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Retail (includes auto
dealers, restaurants and
taverns) |
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Construction (includes
contractors) |
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Services |
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Distribution |
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Transportation,
Communications, Public
Utilities |
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Finance, Insurance, Real
Estate |
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Wholesale |
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Manufacturing (includes
printers, publishers) |
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Not-For-Profit |
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Mining |
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Homebased |
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Public Administration |
Other (specify)
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In Business Since: |
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In Skokie Since: |
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Why are you joining? What do
you expect to get out of
Chamber membership? |
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Number of employees
including owners, excluding
independent contractors?
Full Time:
& Part time
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Please check box below if
"YES" |
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Is the business over 50
percent female owned? |
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Is the business minority
owned? |
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Ethnic Origin?
(optional) |
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Does your company
participate in international
trade (import/export)? |
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Who were you referred by?
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INVESTMENT AMOUNT:
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Amount of Check or
Authorized to charge:
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Number of Employees |
Investment |
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1 only |
$215 |
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2-4 |
$230 |
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5-10 |
$250 |
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11-20 |
$320 |
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21-30 |
$375 |
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31-50 |
$450 |
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51-75 |
$525 |
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76-100 |
$600 |
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101-150 |
$700 |
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151-300 |
$800 |
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301-500 |
$900 |
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501 Plus
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$1000 |
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School Districts & 501c3
NFP $250.00
Hotel/Hospital/Nursing
Home $4.50/per bed
Financial Institution
$700
Optional
Upgrades to Membership:
Membership Plus
Signature add $275
Membership Plus Premier
add $500
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PAYMENT OPTIONS:
Dues are billed on
an anniversary basis, not on
an annual basis. |
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Check is in the mail to 5002
Oakton Street, P.O. Box 106,
Skokie, IL 60077 |
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Please send an invoice to
the company |
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I will contact you at
847-673-0240 to give you my
Credit Card information.
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