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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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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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1-4 |
$210 |
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5-10 |
$250 |
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11-20 |
$295 |
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21-30 |
$350 |
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31-50 |
$415 |
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51-75 |
$475 |
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76-100 |
$550 |
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101-150 |
$650 |
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151-300 |
$750 |
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301-500 |
$875 |
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501 Plus |
$975 |
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School Districts & 501c3 NFP $250.00
Hotel/Hospital/Nursing Home $4.00/per bed
Financial Institution $17 per mil
(minimum dues investment) $600.00 |
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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. |
