Chamber of Commerce of Old Bridge, Sayreville and South Amboy

CHAMBER OF COMMERCE
PO. Box 5241
Old Bridge, NJ 08857
Tel: (732) 607-6340 Fax: (732) 607-6341

email ccommerce@optonline.net

http://www.chamberofcommerceobssa.org

MEMBERSHIP APPLICATION

Application is hereby made for a $________ an annual membership in the
Chamber of Commerce serving Old Bridge, Sayreville and South Amboy
beginning _________________________________ ,and to be renewed automatically unless written notice is given 30 days prior

Firm._________________________________________________________

Address_______________________________________________________

City________________________________ State_________ Zip _________

Phone ____________________________Fax_________________________

Email ___________________________Website _______________________

Business Classification. ___________________No. of Employees __________

Principal Officer _________________________________________________

Member Representative( s)

Name___________________________________ Title ___________________

Name___________________________________ Title ___________________

Name___________________________________ Title ___________________

Branch, Address of Home Office. ___________________________

Sponsor ________________________________________________________

Signature_____________________________________ Date. _____________

(make checks payable to CHAMBER OF COMMERCE)
Dues Structure

No. of Employees	Investment
1	$125.00
2-9	$150.00
10-49	$200.00
50-99	$300.00
100-200	$400.00
Over 200	$500.00

Investment is payable in advance and must accompany application