Business/Organization Name: Type of Business
Contact Name: Title:
Physical Address: State Zip Code:
Mailing Address State: Zip Code:
P.O. Box: Phone: Fax
Email: Facebook:
Website: Twitter:
Check Type of Membership: Individual/Non-Business
Arizona City Chamber of Commerce
13640 S Sunland Gin Rd. (P.O. Box #5) Arizona
City, Arizona 85123
Office Phone: 52-466-5141
Email: azcitychamber@azci.net
Website: www.arizonacitychamber.com/newsite
CHAMBER MEMBRSHIP FORM
ANNUAL DUES & VOTER DESIGNATION INFORMATION
Please Enter Amount Due: $ Pd w/Check # Or Cash $
Remit Payment by Check to Arizona City Chamber – P.O. Box 5 – Arizona City, Arizona 85123
Or bring payment to Chamber Office or give to one of the Board of Directors Member.
The Chamber of Commerce needs signed permission to call, fax, or email you any information we feel is
important to you or your business. If you would like us to contact you for important information please
sign below and designate your preferred method of contact.
Check Contact Method: Phone Email
Signature Date
Individual/Non-Business $40
Owner w/0 employees…. $40 New Member Special
($75 renewal after 1 yr)
2-3 Employees………….. $75
4-9 Employees………….. $120
10+ Employees………….. $150
click to sign
signature
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