104 W. North Main St.
Richmond, MO 64085
816-776-6916
816-776-6917 - fax
Maintaining a strong local economy
Promoting the Community
Providing business networking opportunities


Membership Application

Company Name:

Address: P.O. Box:

City:

State: Zip Code:

Phone: Fax:

Web Page (if available):


E-mail address:




Contact Person:


Job Title:

Type of Business:


Number of Employees:


Month/Year Business Opened:



Membership Investment Level

Associate membership - $50/annually (for individuals
and not-for-profit organizations only)
Regular membership - $200/annually
Bronze membership - $240-$499/annually
Silver membership - $500-$749/annually
Gold membership - $750 and up/annually

Billing options for investments of $200 and up (please check one):

Yearly
Semi Annually
Monthly
Quarterly

Interests/Involvement

Yes, I would like to be involved in one or more of the following (check all that apply):

Education
Communication
Fundraisers
American Celebration
Ambassadorship
Mushroom Festival
Banquets
Christmas Extravaganza
After Hours
Business Expo
Marketing
Membership



Would your business be able to accept Chamber Gift Certificates as payment?


Would you impose any restrictions? If so, please explain


Authorized Signature:

Date



Download our
Membership
Benefits Brochure

click here



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