PERRIS VALLEY CHAMBER OF COMMERCE

							                  PERRIS VALLEY CHAMBER OF COMMERCE
                                           11 South D Street
                                           Perris, CA 92570
                                 (951) 657-3555 Fax (951) 657-3085
                                   MEMBERSHIP APPLICATION

Business Name ____________________________________________ Number of Employees ______

Representative _________________________________________ Title ________________________

Business category _____________________________________________________________________
                   (e.g. printer, furniture manufacturer, etc.) - for business members only

Physical address _____________________________________________
                   _____________________________________________
                   _____________________________________________

Mailing address (if different) _____________________________________________
                                 _____________________________________________
                                 _____________________________________________

Phone _____________________________                 Fax ____________________________________
                                                    Please check one: I ____ give ____ do not give permission
                                                    to the Perris Valley Chamber of Commerce to include my
                                                    company in fax notifications.

Email _________________________________________________
       (the cost-effective alternative to fax! – please give us your email)

Please circle your membership level in the box.              Membership Rates
                                                             Associate Membership (individuals)........ $100
                                                             Non Profit ................................................. $100
                                                             Home Based Business .............................. $130
                                                             Business:
                                                             1-2 Employees ......................................... $170
Are you interested in working on Chamber
                                                             3-9 Employees .......................................... $190
of Commerce projects?
                                                             10-24 Employees ...................................... $230
                                                             25-59 Employees ...................................... $300
______ Yes/maybe, talk to me about it.
                                                             60-199 Employees .................................... $350
                                                             200+ Employees ....................................... $400
______ No, I’m way too busy already.


Signature _____________________________________________                          Date _______________________
             Dues can be paid by check (made out to Perris Valley Chamber of Commerce) or cash.