Tamarac Chamber Membership Application

Calendar of Events .................................... Special Events .................................... Photo Galleries .................................... Membership .................................... Trustee Membership .................................... 2007 Board .................................... Websites .................................... Advertising .................................... Join Now .................................... Tam Net .................................... Tam-Net Referral Group .................................... Online Newsletter .................................... Taste of Tamarac		TAMARAC CHAMBER MEMBERSHIP APPLICATION Business Name: ________________________________________________Date: _________________________________ Representative: _________________________________________________Title: ________________________________ Business Address: ___________________________________________________________________________________ ___________________________________________________________________________________________________ Phone: _______________________________________ Fax: __________________________________________________ Email: ________________________________________ Website: ____________________________________________ Service/Industry: (Detail)_______________________________________________________________________________ Number of Employees: ___________ Referred by: ________________________________________________________________________________________ Membership Fee: ________________________+ $35.00 (One time administration fee) = Total: $_______________________ Check Visa Master Card American Express Account #______________________________________________________Expiration Date:_______________________ Name: _____________________________________________________________________ Please print as name appears on card. Signature: __________________________________________________________________ Yes! I want information on Tamarac Chamber of Commerce news, activities and opportunities. My preferred method to receive this information is: Via Fax Via Email Both _____________________________________________ ________________________________________ Contact name Signature Application Subject to board approval. Print out page fill it out then fax it or mail it to us.