PRINEVILLE - CROOK COUNTY CHAMBER MEMBERSHIP APPLICATION

MEMBERSHIP APPLICATION
Business Name
Contact/Owner Name
Main - Physical Address (To be listed in our Member Directory- Public Access)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mailing Address (if different than main address - For Invoicing)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
I don't want my address to be made public
Business Phone Number
Please enter a valid phone number.
Business Web Address
Main Email Contact
example@example.com
I would like to be included in the Chamber email list.
Secondary or Billing Email Contact
example@example.com
Please list any additional employees that you would like on the Chamber email list.

Name Email
Please list any additional employees that you would like on the Chamber email list.

Name Email
Membership Level

General 1-5 $175.00 Restaurants 1-49 Seats $175.00 General 6-25 $200.00 Restaurants 50+ Seats $240.000 General 26-50 $235.00 Lodging, RV Parks, Campgrounds $230.00 Home Based $150.00 Churches, Governments, Schools, Non-Profits $150.00 Additional Rep/Business $90.00 Individual/Student $85.00 Financial Institutions $310.00
Information/Blurb about your business to share with others
How would you like to be invoiced?

We would like to pay via check - Please invoice us We would like to come by the office and pay with cash
We would like to pay by Credit Card

If paying by Credit Card please fill in information below.

Don't forget to "like" our Chamber Facebook Page so that you know when we tag your business in a post!

https://www.facebook.com/PrinevilleChamber
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