McCleary Community Chamber of Commerce

Membership Application Form

Web Site The information below will only be put on the Chamber web site if the corresponding boxes are checked!

Name / Title

 check this box ___________________________________________

Business or Organization Name
(if applicable)

 check this box ___________________________________________

Description (if applicable)

 check this box ___________________________________________

Street Address

 check this box ___________________________________________

Mailing Address

 check this box ___________________________________________

City, State, Zip Plus Four

 check this box ___________________________________________

Phone(s)

 check this box

Office: ______________ FAX: ______________

Email address
(For meeting notices and calendar updates if "Web Site" box is not checked.)

 check this box ___________________________________________

Internet Home Page

 check this box ___________________________________________

Welcome Packet Donor
(Please describe your gift for McCleary newcomers)

 check this box ___________________________________________

Please make checks payable to the McCleary Community Chamber of Commerce. Mail your payment and the completed Membership Application Form to the address below.
Dues Enclosed (check one) Business Dues $35.00 check this box . Individual Dues $17.50 check this box .

Thank you for your support!


Mail to:

MCCoC
PO Box 53
McCleary, WA 98557-0053


file: mccappform2005.htm

Chamber Use Only:
Dues Received  
Certificate Delivered  
Mailing List Updated  
Web Site Updated  
This page was prepared by InFocus. Updated 01/17/05.