Tamarac Chamber Membership Application

Calendar of Events .................................... Special Events .................................... Membership .................................... Trustee Membership .................................... 2010 Board of Directors .................................... Websites .................................... Advertising .................................... Join Now .................................... Tam-Net Referral Group .................................... TamarAction Referral Group .................................... Online Newsletter .................................... Taste of Tamarac		TAMARAC CHAMBER MEMBERSHIP APPLICATION 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 Application Subject to board approval. Click Here For Partnership Investment Schedule Print out page fill it out then fax it or mail it to us. Phone - 954.722.1520 Fax - 954.721.2725