MEMBERSHIP REGISTRATION FORM

2009

NAME OF PERSON REGISTERING ________________________________________________________

Please Print

COMPANY NAME ________________________________________________________________________

(If you are a renewing member and your information has not changed, you do not need to fill in the information below)

MAIL ADDRESS__________________________________CITY_________STATE____ZIP______________

TELEPHONE______________CELL___________________E-MAIL_________________________________

DO YOU WANT YOUR MAILINGS SENT TO YOUR E-MAIL, YOUR COMPANY OR HOME ADDRESS

E-MAIL______ BUSINESS______ HOME_______

DATE___________________________________________ DUES ARE $35 PER YEAR

PLEASE MAIL COMPLETED FORM AND DUES TO:

HUDSON AREA CHAMBER OF COMMERCE

P.O. Box 605

Hudson, Colorado 80642

303/536-4715

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WWW.HUDSONCHAMBERCO.COM