I/We hereby apply for membership in the Lehigh Acres Chamber
of Commerce, Inc. This membership shall
be in effect for twelve (12) months following the application month. Members not renewing are requested to return
their membership plaques to the Chamber office.
Date of Application: ______________________________ Category: ( )
Business ( ) Group ( ) Individual
Company/Group or Individual Name:
__________________________________________________________
Contact Name:
___________________________________________________________________________
Position: _________________________________________ Title:
__________________________________
Address:
________________________________________________________________________________
City/State/Zip:
____________________________________________________________________________
Phone Number: ______________________________ FAX Number:
________________________________
Website: _____________________________________ Email:
_____________________________________
Occupational License #: _____________________ Business
Category: ______________________________
(see list on back)
Number of Full and Part-time Employees: _____________ Number
of Sales Agents: ________________
Applicant Signature:
_______________________________________________________________________
One-time Administrative Fee: _____$25.00
Twelve Month Dues: +___________
Total Payment: =___________
Committees I would like to join:
___ Ambassadors ___ Art Auction ___
Budget ___ Building ___ Business/Community
___ Circus ___
Education ___ Golf Tournament ___ Government Affairs ___
Incorporation
___Leadership Lehigh
___ Legal ___ Membership Development ___ Membership Retention
___ Public Relations
___ Special Events
___ Strategic Planning ___
Technology
aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa
Office Use Only:
Received by: __________ Date:
__________
Mailing
Address: Post Office Box 757, Lehigh Acres, Florida 33970
Email: lehighchamber@comcast.net
website: www.lehighacreschamber.org