MEMBERSHIP APPLICATION

Please ll out and remit to a Chamber representative. Feel free to contact the Chamber at 801-466-3377 with any questions.
South Salt Lake

CHAMBEROFCOMMERCE

PRIMARY CONTACT: TITLE:

BUSINESS NAME: MEMBERSHIP: $165 (1-11 EMPLOYEES) $300 (12-50 EMPLOYEES) $385 (51+ EMPLOYEES)

DESIGN DISTRICT MEMBERSHIP ($300) ADDRESS: ADDRESS 2: CITY/STATE: E-MAIL/WEBSITE: PREFERRED METHOD OF CONTACT: BUSINESS CATEGORY: BILLING ADDRESS: BILLING ADDRESS 2: CITY/STATE: ZIP: PHONE: ZIP: PHONE:

I hereby apply for membership for the South Salt Lake Chamber of Commerce. I agree that my Annual Investment Dues will be $______________, payable on an annual basis. Signature: _________________________________________ Date: ____________________ Secured By: _______________________________________ Date: ____________________

Mail To: SSL Chamber of Commerce PO Box 65001 Salt Lake City, UT 84115

Would you like to put a credit card on le for easy payment at events and luncheons? Credit Card Number: Expiration: CCV:

Are you interested in doing event sponsorships or having an Executive Membership? Not Now Yes, please send me more information.