Membership Application
Business Name:
Contact Name:
Street Address:
City:
State:
Zip:
Mailing Adress:
City:
State:
Zip:
Phone:
Toll-Free No.
Fax:
E-Mail Address:
Web Address:
Type of Business:
Description of Services:
Number of Employees (for Schedule 9):
Of those employees, how many are:
Full Time
Part Time
Seasonal
Number of: units/campsites/seats (schedule 1,2,6 or,8)
Amount of Investment $
Member Sponsored By:
Copyright 2002 by Brunswick County Chamber of Commerce. All rights reserved.
