If you would like to become a member of the Nelson County Chamber of Commerce, please PRINT and complete the application below and mail it to the chamber office.
APPLICATION FOR MEMBERSHIP
Annual Dues For Individual Membership $25.00
Annual Dues For Business Membership
10 or less employees $50.00
11 – 25 employees $75.00
Over 25 employees $125.00
NAME ____________________________________________________________________________
(Applicant for Individual Membership)
NAME of BUSINESS_________________________________________________________________
(Applicant for Business Membership)
BUSINESS OWNER OR CEO _________________________________________________________
ADDRESS _________________________________________________________________________
CITY, STATE, ZIP ___________________________________________________________________
TELEPHONE _______________________________________________________________________
(Work) (Home)
EMAIL ADDRESS ___________________________________________________________________
Would you be willing to serve on one of the Chamber’s Committees?
_________ Yes __________ No _________ Maybe
Would you be willing to serve on the board of Directors if nominated and elected?
_________ Yes __________ No _________ Maybe
If this is an application for a Business Membership and the Head of the firm is unable to participate in Chamber activities, please give the name of an individual in your business that would be willing to serve on a committee and/or be the Chamber’s contact:
NAME of CONTACT_________________________________________________________________
Please return with payment to:
Nelson County Chamber of Commerce
P. O. Box 182
Lovingston, VA 22949
For Office Use
Submitted by: __________________________________________ Date: _________________________
Approved: ____________________________________________ Date: __________________________