Canby Chamber of Commerce - Membership Application

Canby Chamber of Commerce
Membership Application (Paper)
Online form available if desired.

Print this page and send or FAX to addresses below.

Investment Schedule/Rate
General Business (Commercial, Manufacturing, Industrial, Financial)
Number of Employees (including owner/operator)	Investment Rate

1 to 5	$175.00 year
6 to 10	$240.00 year
11 to 25	$310.00 year
26 to 50	$441.00 year
Over 50	$441.00 + $2 per employee over 50 (negotiable)


*Other*
Financial Institutions	$248.00 year
Farms/Nurseries	$171.00 year
Schools, Government Agencies/Utilities	$378.00 year
Non-profit/Churches	$147.00 year
Home Based (no employees)	$93.00 year
Individual Agent/Consultant	$93.00 year
Individual/Non Business	$80.00 year
Multiple Businesses (same owner with 1-5 employees)	$78.00 year

Applicant Information

Business Name: ___________________________________________________________

Owner: ____________________________ Manager: _____________________________

Street Address: ___________________________________________________________

Mailing Address: __________________________________________________________

Phone Number: ________________________ Fax Number: ________________________

Cell Phone Number: ____________________ Web Site: ___________________________

E-mail: _____________________ Years in Business: _____ Number of Employees: _____

Rates
	Membership Rate	$________
	Application Fee	$__20.00_
	6 Pre-paid Chamber lunches ($10 each, $60 total)	$________
	*TOTAL DUE*	$________

Please use the back of this form to write a description of your business for our newsletter

Canby Area Chamber of Commerce
191 SE 2nd Ave.
PO Box 35
Canby, OR 97013
503-266-4600
fax 503-266-4338
E-mail - chamber@canby.com