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Est. 1936
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MEMBER INFO
OUR COMMUNITY
CHAMBER BUSINESSES
EVENTS CALENDAR
501 E. High St.
Potosi MO 63664
573.210.9734
Newsletter
Est. 1936
Toggle Navigation
HOME
MEMBER INFO
OUR COMMUNITY
CHAMBER BUSINESSES
EVENTS CALENDAR
Member Application
Home
Chamber Info
Member Application
Member Application
Chris Sisk
2022-09-28T21:44:50-05:00
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*
" indicates required fields
Name of Business
*
Date of Application
*
MM slash DD slash YYYY
Choose One:
New Member
Renewal Member
Business Physical Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
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Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Mailing Address (If different)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Type of Business (Key Words)
*
Phone
*
Fax
Business Representative/Contact
*
First
Last
Representative Cell Phone
Business Email
*
Primary's Email
Secondary Representative/Contact
First
Last
Secondary's Cell Phone
Number of Owners
*
Number of Full Time Employees
*
(Each employee working 20 hours or less counts as 1/2 Full Time employee)
Number of Part Time Employees
*
Website Address
For Link on Chamber site
Social Media
(add additional rows by clicking the plus button on the right)
Platform (i.e. Facebook)
Link
Add
Remove
Business Hours
(add as many as you need by clicking the plus button)
Day (s)
Time
Add
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Stripe has a 2.9% plus 30 cents per transaction Processing Fee
For more information on Stripe and its processing fee
click here
Membership Options
*
(choose one)
Level 1: Individual or Not for Profit - $100.00
Level 2: Small (1-50 Employees) - $125.00
Level 3: Corporate (51 employees and above) - $175.00
Gold Sponsor Membership (info below) - $1000.00
Platinum Sponsor Membership (info below) - $1500.00
Gold Sponsor Benefits
Logo featured on website with link to member’s website
Logo displayed on every page on website
Logo on banner displayed at Chamber/IDA office
Logo on banner displayed at monthly general meeting
Verbally and visually acknowledged at all meetings
Logo on chamber weekly newsletter
Logo on banner at all Chamber events
Membership Dues
First right renewal for limited 12 sponsors
Platinum Sponsor Benefits
Plus all of the Gold Sponsor Benefits
Flower Festival (May)- $ 100 level
Home Grown Farm Tour (August)- $500
Golf Tournament (October) $100 level
.1k Run (November) $50
Total
Credit Card
Card Details
Cardholder Name
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