Maumee Chamber of Commerce Membership Application
	Name: Company: Nature of Business: Your Title: Street Address: Mailing Address: (if different) City: State: Zip:
	Phone: Email: Fax: Web Address:
	Dues Structure: 1-5 Full Time Employees ($135.00) 6-10 Full Time Employees ($165.00) 11-25 Full Time Employees ($235.00) More than 25 Employees ($295.00) 2 Part time employees = 1 Full time employee. Additional active members from the same organization, add $40 each.
	I understand that by submitting this form I will be invoiced for the above service. I also understand that my company's membership will not be activated until payment is received. Thank you.