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Application for Membership

Membership Application

Business Name *

Contact Name *

Address *

Address

Address

Address

City

City

State/Province

State/Province

Zip/Postal

Zip/Postal

Phone Number *

Email Address *

Website/URL

Type of Business *

The Undersigned Makes Application For *

(Choose only one per application)

Number of Employees *

Authorized Signature *

Title *

Date

By submitting this form, you agree to pay the applicable membership fees. Once you click Submit, you will be given the option to select your membership payment. It is understood that this membership is to be continued unless canceled in writing.

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Business

$215/yr

1-4 Employees $215
5-9 Employees $240
10-19 Employees $345
20-29 Employees $450
30 Plus Employees $555

Professional

$265/yr

Physicians, Attorneys, Accountants, etc.
Plus $50 per Firm Member.

Individual

$135/yr

Individual Who Supports The Chamber, But Has No Business Affiliation.

Financial Institution

$840/yr

Banks, Credit Unions & Investment Companies.

Home Based Business

$165/yr

Scentsy, Mary Kay, Paparazzi, Avon, Lipsense, etc.

Non-Profit Organization

$135/yr

501 (c) 3 Organizations Such As Churches & Civic Organizations.

206 N Bickford Ave • El Reno, OK 73036 • 405.262.1188

Monday - Friday 9am - 5pm

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