APPLICATION FOR MEMBERSHIP
Front Royal-Warren County Chamber of Commerce
"Connecting Business and Community"
  *indicates required field 
* Company/Organization Name:   
* Contact Person:   
Title:   
* Address:   
   
* City:  * State:  * Zip: 
E-Mail Address:      URL:   
* Area Code & Phone:  *(i.e. 540-984-5224)  Fax:   
* Type of Membership (select one):   
* Number of Employees:  Full-time Part-time  
* Type of Business/Product or Service Provided:   
Membership Directory Listing: 

(Members will be listed in one business category. Each additional listing is $25 per year. Must be a member in good standing to appear in the Directory.)
1. (Choose 1 FREE listing):   
2. Additional category listing @ $25 yearly: (1) 
(2) 
Membership Investment  
  TOTAL AMOUNT OF INVESTMENT: ........... $
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  ADDITIONAL DIRECTORY LISTING ($25 EA)  $
  ADMINISTRATIVE FEE (New Members Only)  $
  GRAND TOTAL:  .......................................$
* Method of Payment:   Credit Card Check
Check:   Routing Num:    Check Num:  
Discover/Mastercard/Visa:   Card Number:   Exp. Date:   

I/We understand that the membership investment in the Chamber may be tax deductible as an ordinary and necessary business expense and is not charitable tax deduction for Federal Income Tax purposes. Membership will renew itself annually unless written notification of cancellation is received. Investment paid is non-refundable. The Chamber reserves the right to revoke membership for conduct unbecoming a member, as determined by the Chamber Board of Directors.

* Signature of Applicant:   
Date Submitted: