Registration Form PUBLIC INFORMATION – THIS INFO MAY BE AVAILABLE TO THE PUBLIC ON THE CHAMBER WEBSITE AND/OR SOCIAL MEDIACompany/Firm/Organization Name Contact Person Position/Title Mailing Address Physical Address City BC Postal Code Business Phone(Required)Mobile or Toll-FreeBusiness Email(Required) Website Social Media SitesDescription of business/organization (services, main products offered)Are you interested in learning more about Chamber Group Plan benefits? Yes No Participate in Chamber Bucks Program Yes No *Please Circle the categories that best suit the business or organization. This information will determine the categories the business is listed under on the website. *Accountants Agriculture Aircraft All Terrain Art & Design Automotive Breweries/Pub Building Supplies Business & Employment Catering Clothing Community & Non Profits Computer/Internet Contractors Consulting Electronics/phones Education Equipment Rentals Excavating/Gravel Farmers market Feed & Ranch Supplies Finance/Banking/Investing Flooring Floral/Gifts Forestry/Industry/Mining Funeral Services Garden Glass/Auto Glass Grocery Stores Health & Wellness Home Hotels/B&B /Resorts Insurance Legal Services Music Marine Newspapers/Radio/Media Pharmacy Office Supplies Painting Pets and Vet Supplies Printing & Photography Plumbing & Electrical Ranches Real Estate Recycling & Disposal Restaurants Retail Septic/Hydrovac Recreation/Camps Sporting Goods Sports/Rec Teams Storage Tanning Transit Truck Service Repair Watch/Jewellery OTHER? PRIVATE INFORMATION –INFORMATION ON THIS FORM WILL NOT BE SHARED PUBLICALLYLength of time in business Average # of employees throughout the year: Full time Part time NEWSLETTER EMAIL PERMISSION: Yes No Email Address(Required) Emergency contact info in addition to business contact information Cell Phone/Personal #*Only to be used in the case of a state of emergency*Schedule of Annual Membership Investment Assessments (Membership Fees) # of Employees (average) Membership GST Total Annual Fee Home-base No Employees 109.25 5.75 $115.00 1-2 130.15 6.85 $137.00 3-4 150.57 7.93 $158.50 5-9 172.9 9.1 $182.00 10-15 199.5 10.5 $210.00 16-20 233.7 12.3 $246.00 21-50 289.75 15.25 $305.00 51+ 457.9 22.5 $482.00 Non-Profit Association 59.05 2.95 $62.00 Non-Voting Associate 87.4 4.3 $92.00 2nd Business/Same Location 51.3 2.5 $54.00 **Fees have been rounded for processing**Amount of membership fees due $Payment can be made by Mastercard, Visa, cheque or cash.NEW: We now accept e-transfers sent to [email protected]I hereby continue membership in the South Cariboo Chamber of Commerce. I understand and agree that membership contract will remain in effect until I resign, after giving 10 days advance notice in writing, and that my membership is due and payable now. I understand that the business membership will attach to the company named above, and not to any individual, and is non-transferable. Fees are payable annually for the period of one calendar year. Membership dues received by the Chamber of Commerce are non-refundable. New members (excluding past members) may be eligible for prorated membership dues if registered late in the year.Business Authorized SignatureDate MM slash DD slash YYYY Authorized Personnel Name Position/Title PhoneThis field is for validation purposes and should be left unchanged.
