Join the Chamber

03/31/2009 — Jonathan Packer

Thank you for joining the Killeen Chamber. After completing the following form a member of the Chamber staff will contact you.

Member Information

Company (Or Individual) Name: *

Telephone: *

Fax:

Alternate Phone:

Toll Free Phone:

Email: *

Website Address:

Who Talked to you About the Chamber?:

Phyisical Address

Address: *

City: *

State: *

Zip Code: *

Mailing Address (If Different)

Address:

City:

State:

Zip Code:

# of Full Time Employees: *

# of Part Time Employees: *

Business Categories

Primary: *

2nd Business Category:

3rd Business Category:

Primary Representative

Name: *

Title: *

Phone:

Cell Phone:

Fax:

Email: *

Unless otherwise specified in the "comments" block below, the primary representative will also be recorded as the billing contact.

Secondary Representative

Name:

Title:

Telephone:

Cell Phone:

Fax:

Email:

Third Representative

Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Billing Information

# of Emps	Investment
1 - 3	$210
4 - 9	$225
10 - 19	$275
20 - 29	$325
30 - 39	$450
40 - 49	$550
50 +	$550 plus $5 for @ employee
Admin Fee for all New Members	$25 (Please include in all totals)
Non-Profit Orgs	$125
Ind Members	$125
Assoc Members	$125
Banks & Financial Inst	$25/$1 mil in deposits
Retired Members 60+	$75
Be sure to include $25 Administrative fee for all new memberships.

Amount to be Billed: *

Please reference spreadsheet above to calculate membership amount. Remember to include $25 adminsitration fee for new memebrs.

We hereby make application for membership into the GKCC. If approved, we agree to an annual investment of: *

GKCC membership dues, gifts, contributions and the purchase of publications, subscriptions and services are not tax deductible as charitable contributions for federal income tax purposes. However, GKCC membership dues and the purchase of GKCC publications, subscriptions and services may be tax deductible as ordinary and necessary expenses. I understand and agree that our financial commitment is renewed annually until we request, in writing, our membership be discontinued. I understand that $5.00 of our annual dues is applied to subscription to the “Front and Center” publication. I further understand that by providing the fax number(s) and e-mail addresses above on behalf of the company/organization/individual specified above, I am authorized and do hereby consent for the company/organization/individual to receive faxes and e-mail sent by or on behalf of the Greater Killeen Chamber of Commerce.

Note that all membership applications are subject to the approval of the Board of Directors of the Greater Killeen Chamber of Commerce.

I understand that I will be billed for the amount stated above once my application is approved by the board of directors. I further understand that after approval my membership will become effective only after payment of dues is received in full.

Comments or Additional Information:

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