MEMBERSHIP APPLICATION

Application Date: ____________________________         New:___________                      Renewal:___________

Application is hereby made for membership to the Rio Linda Elverta Chamber of Commerce by the undersigned firm, organization or individual.  By this application, agreement is made to comply with the By-Laws by which the Rio Linda Elverta Chamber of Commerce conducts its business.

FIRM NAME: _______________________________________________________________________________

BUSINESS FORM: __Sole Proprietor  __Partnership __Corporation __LLC __Individual  __Organization __ Other(Please check one)

BUSINESS ADDRESS: _______________________________________________________________________

MAILING ADDRESS: _________________________________________________________________________

OWNERS/OFFICERS:________________________________________________________________________

DESIGNATED REPRESENTATIVE:_____________________________________________________________        

PHONE: ___________________________________FAX;____________________________________________

TYPE OF BUSINESS: ________________________________________________________________________

E-MAIL ADDRESS: __________________________________________________________________________

WEBSITE URL:_____________________________________________________________________________

NUMBER OF EMPLOYEES       FULL TIME: ____________________       PART-TIME: _____________________

SIGNATURE: ___________________________________TITLE: ________________DATE:________________
Please consider an additional, voluntary contribution to support the expenses incurred by the Chamber for maintaining the office in the Sacramento Northern Depot/Visitors Center.

ANNUAL MEMBERSHIP FEE SCHEDULE 

1 to 5 Employees                      $50.00   (Also applies to Resident & Organization memberships)

6 to 13 Employees                    $75.00

14 or more Employees            $150.00

Referred by: ___________________________________________________________________