2012 Membership Form

I hereby apply for membership in the Merritt & District Chamber of Commerce.I understand and agree that this membership contract will remain in effect until I decide not to renew and give 10 days advance notice in writing, and that my annual membership is due and payable on or before the anniversary date. I understand that business memberships attach to the company named here and not to any individual, and are not transferable. Fees are payable annually for a period of one calendar year, from January to December, and are not refundable.

Membership Anniversay Date: ________________________________________

Business Name: ___________________________________________________________________

Mailing Address: ___________________________________________________________________

Street Address: ____________________________________________________________________

City: _________________ Prov: __________________ Postal Code: _____________________

Phone: ____________________ Fax:_____________________________E-mail: _____________________

Website: ___________________________________________________________________________

Owner/Manager: _____________________________________________________________________

Website Listing: Give a brief discription of your business (up to 200 characters), plus three key words as links.

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________

Membership Category: Fee:            HST:             Total:

Businesses and Non-Profit (Employess)..................$195.00.......$23.40...........$218.40

Individual Membership.......................................$120.00........$14.40..........$134.40

Home-Based Business & Non-Profit (No Emplyees)..$120.00........$14.40..........$134.40

Please keep a copy of this form for your records. A reciept will be issed after payment with your 2011 Business card and decal.

Remeber your membership fees are deductible.

Amount Paid: $_____________________

Date Paid: _____________________ Cash:_____Debit:_________ Chq#:_________CC:_______

To submit your application please fill out and fax to 250 378-6561, e-mail to  This e-mail address is being protected from spambots. You need JavaScript enabled to view it

or drop off at 2185B Voght Street Merritt BC.