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Membership Application

Complete the form and print it out.

Remit with your check to the
Warwick Valley Chamber of Commerce.
PO Box 202, Warwick, NY 10990
We also accept credit cards.

Applicant Information

Company Name:
Contact Name:
Address:
City, State, Zip:
# of Employees:	Full Time Part Time
Phone:
Fax:
Email Address:
Category/Type of Business
Website URL:

Signature

Name:

Title:

Signature of Applicant:

Date:

Select type of membership you would like.

	Corporate Membership	$350	Sixteen or more employees; Up to two representatives.
	Medium Business Membership	$250	Seven to fifteen employees; Up to two representatives.
	Small Business Membership	$150	One to six employees.
	Non-Profit Membership	$75
	New Business Membership	$115	Any business in operation less than one year. Documentation is required.
Tell us a little about your business.

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