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New Member Application

Company Information
Company:
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Address Line 1:
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Address Line 2:
City:
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State:
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Zip:
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Phone 1:
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Phone 2:
Fax:
E-mail:
*
Website:
Bus. Category 1:
Full-time Employees:
*
Part-time Employees:
*
Members-only Account Login
Members-only allows you to update your information online via a secure login.
Admin E-mail:
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Password:
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Verify Password:
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Contacts
Primary Contact
Prefix:
First Name:
*
Last Name:
*
Suffix:
Familiar Name:
Title:
 
Billing Contact
 
Annual Membership Dues
# Employees
Annual Dues
1
160.00
2-3
230.00
4-10
305.00
11-20
455.00
21-50
605.00
51-100
760.00
101-199
1,200.00 + $1 for each over 101
200+
1,450.00 + $1 for each over 200
$160.00
$230.00 base plus $3.00 per unit over 15
$230.00
To be negotiated by Executive Committee.
$160.00
$70.00
Total:
$0.00
In order to assure the continued economic growth and overall development in Crisp County and with the firm belief that an adequate budget is necessary for the purpose, the undersigned herby applies for membership in the Cordele-Crisp Chamber of commerce and agrees to pay $0 annually as the cost of maintaining the Chamber program. This amount is due at joining. You will be billed annually in accordance to your sign-up date.
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