Port Washington, Wisconsin
Information Request
Port Washington, WI Chamber Membership

PORT WASHINGTON, WI CHAMBER OF COMMERCE
PO Box 514  Port Washington, WI 53074
Phone 262-284-0900   mary@portwashingtonchamber.com  Fax 262-284-0591
MEMBERSHIP INVOICE

INVOICE/Membership Form

JULY 1, 2010 – JUNE 30, 2011
Business __________________________________________ (Exactly how it will be printed in the City Guide and on the Web)
Contact ________________________________________________
Address ________________________________________ City/Zip __________________________
Phone _________________________________          Fax ________________________
Email * ____________________________________Web Site____________________________________               
Check                                                               Early Bird DUES                    Pay DUES After
One                                                                  Pay by June 30, 2010        June 30, 2010
___0 – 5 Employees……………..………………………………$184.00……………………………$200.00
___6 – 25 Employees…   ………………………………………$225.00……………………………$248.00
___26 – 50 Employees………………………………………… $291.00……………………………$318.00
___51 – 100 Employees……………………………………..…$345.00……………………………$379.00
___101-500 Employees…………………………………………$554.00……………………………$604.00
___501 + Employees…………………………………………….$684.00……………………………$745.00
___Non-profit 1-50 employees……………………………...$115.00…………………………...$122.00
___Associate Membership……………………………………..$83.00……………………………..$95.00
(Associates are non-profits with no paid employees, retirees, and independent contractors of a business with paid memberships.  Associates may participate in all chamber programs as a full member.)

Your first (basic) listing in the City Guide and on the web site is a membership benefit.  Additional listings are $25 per category to be listed in the City Guide and on the web site.  Please place an “X” in one Basic and an “X” for each additional listing.  You may have only one Basic listing in total.  You may have as many additional listings as you wish to pay the additional $25.
                   
Advertising/Marketing                  Environmental Services                         Newspapers             
Apartment Rental                         Festivals                                                Nightlife                   
Architects                                                     Financial Service                                    Outdoor Education   
Association                                   Fishing Charters                                    Printing                      
Attorney                                       Fitness                                                   Real Estate                
Automotive                                   Funeral Services                                    Retail                        
Arts, History & Culture                 Gas & Convenience                               Salons & Spas           
Building Services                           Golf                                                        Service Clubs            
Business Services                         Government                                          Telecommunications  
Catering                                       Grocery/Specialty Food                         Theater                                    
Coffee House                               Home Improvement                               Travel Services         
Computer Services                       Industrial/Manufacturer                        Worship/Church      
Dining                                           Insurance Service             
Education                                                     Internet Services          
Employment Services                   Lodging                                                                                                                                                                                                    Medical/Dental/Health       
                                                     Meeting Space                                                              TOTAL ADDITIONAL  $_____
* Newsletter is only sent via email                                                                                                      TOTAL DUES     +$_____
            GRAND

Office Use

Data Base___
Decal ___
Web Site ___
TOTAL $____
Payment by:       Check ___   M.C. ____   VISA ____
Name on Card _______________________________
Credit Card Number __________________________
Expiration Date ______________________
Total to be charged  $_________________
Membership in the Chamber of Commerce may be tax deductible as an ordinary and necessary business expense.  Dues paid to the Chamber are not a charitable tax deduction for federal income tax purposes.  The Chamber is not a charity, but serves as an advocate for area business and industry.