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TAMARAC CHAMBER
MEMBERSHIP APPLICATION
 

Click Here For Partnership Investment Schedule
Please print this page, fill it out entirely
and fax or mail it to us!
Phone - 954.722.1520   Fax - 954.721.2725
7525 Pine Island Rd. Suite#103 • Tamarac, FL 33321

 

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

Membership fee includes one location and 2 representatives. Application Subject to board approval.

 

 

 

tccMini

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