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Newton Area Chamber of Commerce & Visitors Bureau
500 N Main St. Suite 101
Newton, Kansas
67114-2211

Toll Free: (800) 868-2560
Phone: (316) 283-2560
Fax: (316) 283-8732

info@thenewtonchamber.org
Related Sites:
Online Marketplace
The Newton Kansan US Chamber Kansas Chamber
Membership Form Print E-mail
Membership

NEWTON AREA CHAMBER OF COMMERCE AND VISITORS BUREAU
MEMBERSHIP RECORD INFORMATION


Business Name: ________________________________________________________________

Contact Name: __________________________________________________________________

Directory Listing Address: __________________________________________________________

Mailing Address: _________________________________________________________________

City/State/Zip: ____________________________________________________________________

Phone: ______________________________Fax: ________________________________________

Email: _______________________________Website: ____________________________________

Anniversary Month: circle one     SEP  OCT  NOV  DEC  JAN  FEB  MAR  APR  MAY  JUN  JUL  AUG

Membership Dues Amount $_________________         Category: ____________________________

Additional Representatives (1 representative for each $100 invested in membership dues)

Name: ____________________________________ Email: ________________________________

Name: ____________________________________ Email: ________________________________

Name: ____________________________________ Email: ________________________________

Name: ____________________________________ Email: ________________________________

Name: ____________________________________ Email: ________________________________

Name: ____________________________________ Email: ________________________________

Business Description (brief description for use in the newsletter)

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

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© Copyright 2008 Newton Area Chamber of Commerce and Visitors Bureau. All Rights Reserved.