2023 Membership / Partnership Application

Fleming County Chamber of Commerce
2023 Membership / Partnership Application
Please complete the contact information portion of this application so that we may update our records.

Please complete and stop in at our office to pay or mail a check to PO Box 24, Flemingsburg, KY, 41041. We can also invoice.

We are currently in the process of adding a credit card payment.
Name of Individual, Business and/or Organization*
Contact Person*
Title
Mailing Address*
Telephone #*
Fax #
Year Business/Organization was Established
Total # of Employees (Full Time)
(Part Time)
Business Website*
EMAIL ADDRESS*
example@example.com
Facebook Name (if one is created)
Platinum ($1000) (includes Membership fees)
Gold ($750) (includes Membership fees)
Silver ($500) (plus add the amount of general membership ex: $500 +$175 = $675)
Bronze ($250) (plus add the amount of general membership ex: $250 + $175 = $425)
Copper ($150) (plus add the amount of general membership EX: $150 $175 = $325)
General Membership Investment Schedule

*Sole Proprietorship, Individuals, Families, Farms ... $75.00

*Civic & Fraternal Groups .................................. $75.00

*Business (Investment based on # of employees)

- 3 or less employees ......................$125.00

- 4 to 50 employees ......................$175.00

- 51 + .......................................$275.00

*Professionals (Attorneys, CPAs, Dentists, Health Agencies, Medical Offices, etc..............$225.00

*Undergraduate Schools ..................................$275.00

*Colleges, Universities & Technical Schools............$325.00

*Hospitals, Nursing Homes & Pharmacies..............$325.00

*Utilities .....................................................$375.00

*Banks ....................................................... $375.00
Form of payment:*

Mail checkIn person payCredit Card (when it is available)
Amount that will be paid*
Should be Empty:

Fleming County Chamber of Commerce

2023 Membership / Partnership Application