St. John Chamber Web site http://www.stjohnchamber.com

MEMBERSHIP APPLICATION

I (we), the applicant(s), hereby agree to participate with the fellow business community members of the St. John Chamber of Commerce to promote economic prosperity and, therefore, apply for membership and agree to pay the annual dues ($100.00 if joining between January 1st and June 30th; $50.00 if joining between July 1st and December 31st; $100.00 annually thereafter). By applying for membership, it is agreed that payment of annual dues shall continue from year to year unless modified or cancelled in writing while in good standing. Paid membership entitles the member to one listing(each addtional is 25.00) in the Chamber directory, which is distributed to residents in St. John, and other Chamber businesses. The membership directory is also mailed upon request to businesses and new residents interested in learning about our local community. In addition, member businesses are presented with a membership plaque at one of the scheduled monthly meetings and your business will be listed on the Chamber Web site.

Please complete the following:

*Business Name:

*Contact Person's Name:

*Contact Person's Title:

*Business Address for Directory:

*City:

*State:

*Zip code:

*Business Phone:

Business Fax:

E-mail Address:

Web Site Address:

Billing Address (if different):

City:

State:

Zip code:

Year The Business Was Organized:

Type of Business:

Products or Services Provided:

I/We would like to participate on the following Chamber Committees (please select all that apply):

Scholarship Program	Breakfast with Santa
Golf Outing	Breakfast with the Easter Bunny
Corn Roast	Misc. Chamber Events

Sponsoring Member:

Please mail this completed application, along with a check for your membership dues, to the chamber office for processing. You can send your application and payment to:

St. John Chamber of Commerce
9495 Keilman St.
St. John, IN 46373

Once your membership has been approved, your company representative will be presented with a membership plaque at one of the scheduled monthly meetings, your business will be listed on the Chamber Web site and your business listing will appear in the next printed membership directory.

Date:

Signed

JANUARY 2012 NEWSLETTER