Grant, AL Chamber of Commerce

Membership Application

Please complete the below membership investment agreement and we will be in touch with you shortly...

**Business Membership fee is based on the number of employees you have working for you. 
    0-5  Employees $100        13-19  Employees $150
    6-12 Employees $125        20 +  Employees $200

Business Name *
Address *
City *
State *	----AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming
Postal Code *
Contact Person *
Type of Business *
Number of Employees *	0-5  6-12  13-19  20+
Contact Number *
Email Address *
Website Address
Comments
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