MEMBERSHIP APPLICATION & SURVEY FORM

( ) NEW - ( ) RETURNING MEMBER

Membership Dues $25.00 - Checks Payable to Hayfork Chamber of Commerce

Hayfork Chamber of Commerce

P.O. Box 191

Hayfork, CA 96041-0191

Member Name (First, MI, Last)_____________________________________

Mailing Address:_________________________________________________

City: ______________________ State _______ ZIP ____________________

Phone(Home): (____) _____-________ Phone(Work): (____) _____-_______

E-mail: ________________________________________________________

Business Name __________________________________________________

Website:________________________________________________________

Address:________________________________________________________

City: ______________________ State _______ ZIP _____________________

Phone(Work): (____) _____-________ FAX Phone: (____) ______- _______


 
() Help with newsletter production () Help with website content
() Work on brochure projects () Man information booth at public events
() Help with bookeeping  () Represent HCC at Northstate meetings
() Help with meeting programs () Help prepare food for HCC functions
() Help with HCC grant writing () Help with Membership Drive"
() Help with emergency preparedness projects () I would like to______________________
() Help with secretarial work () Drive others to HCC meetings
() I would like to know more about HCC () I would like to help with marketing projects
() I would like to help make signs () I can display HCC information signs in my business