Corning Chamber of Commerce  Membership Application

 

Business Name:__________________________________________

 

Contact Name:___________________________________________

 

Title:___________________________________________________

 

Street Address:___________________________________________

 

Mailing Address:__________________________________________

City, State, Zip:___________________________________________

 

Phone:__________________________________________________

 

Email:___________________________________________________

 

Web Site:________________________________________________

 

Annual Membership Investment:

[  ]  Individual - $35.00

[  ]  Non-profit - $50.00

[  ]  0-5 Employees - $75.00

[  ]  6-10 Employees - $125.00

[  ]  11-20 Employees - $175.00

[  ]  Over 20 Employees - $225.00

Additional Investment Opportunities:

[  ]  Gold Membership - $100.00

Please Remit to:  Corning Chamber of Commerce, 1110 Solano Street, Corning, CA 96021