MEMBERSHIP APPLICATION
ERIE COUNTY CHAMBER OF COMMERCE
P.O. BOX 620
SANDUSKY, OHIO  44870
PHONE (419) 625-6421      FAX (419) 625-7914
BUSINESS NAME
STREET ADDRESS
CITY
STATE
ZIP CODE
MAILING ADDRESS
If different from street address
E-MAIL
WEB SITE ADDRESS
PHONE NUMBER
800 NUMBER
FAX NUMBER
# FULL TIME EMPLOYEES
# PART TIME EMPLOYEES
TYPE OF BUSINESS
DESIGNATED MEMBER
BILLING: ATTENTION OF
ANNUAL DUES LEVEL
PLEASE SEND ANY COMMENTS OR QUESTIONS AND TELL US WHY YOU WISH TO BECOME AN ECCC MEMBER.
Please return all pages when printing this form.

CHAMBER OFFICE USE  

DATE APPLICATION RECEIVED:                                       CLASSIFICATION:                                                            
DATE PAYMENT RECEIVED:                                                RENEWAL DATE:                                                             
CERTIFICATE DATE: ________________________

Added to Web        Billing       
ACT   Buyer’s Guide – Word   
QuickBooks   Membership Directory - Word     
Labels   Industry -   Word  
Mailing  –  Excel   Clubs & Organizations - Word     
Membership  – Excel   Newsletter New Member List  
         

NEW MEMBER PROCESSING: File ___ Cover Letter ___ Certificate ___ Label ___  
Inserts – Member Info Order Form ___; Newsletter Guidelines __ ; Chamber Checks __;
Long Distance Program __ ; Worker’s Comp ___ ; Business Cards ____  
Date Member Packet Mailed __________________