Chamber Membership Registration Form

If you prefer to print the application form, view a printable PDF version here.

Bold fields are required

 
Name of Company:
Contact Person:
Mailing Address:
Street Address:
(if different)
Telephone: Fax:
Toll-free: Mobile:
E-Mail: Show on Chamber
Website
Website:
Brief description of your business or industry
(please complete even if you are renewing):
0 of 255 characters used.
Can you volunteer to sit on a Chamber Committee?
If so, which area interests you?
Do you require a receipt?    
Please tick box to confirm (anti-spam):  

Prorated Membership Fees
 20102011
January$85.00$100.00
February$78.00$92.00
March$71.00$84.00
April$64.00$75.00
May$57.00$67.00
June$50.00$59.00
July$43.00$50.00
August$36.00$42.00
September$29.00$34.00
October *$122.00$125.00
November *$115.00$117.00
December *$108.00$109.00
* Includes next year.
Memberships paid by December 1, 2010
receive a $15 discount.

Please make your cheque payable to "Newcastle and District Chamber of Commerce" and mail to:
20 King Ave. W., Box 11
Newcastle, Ontario L1B 1H7.