Become a Streator Chamber Member!


Business Information


Business Name

Street Address

PO Box

City
State
Zip Code:

Phone
Fax

Email
Website

Business Classification

Number of Employees


Contact Person(s)


Name:

Title:

Name:

Title:


Billing Information (Optional)


Billing Address is the same as above.

Business Name

Street Address

PO Box

City
State
Zip Code

Phone

Billing Officer

Billing Officer Title

Amount of Annual Investment $

Recommended by


This investment is payable in advance and is continuous unless cancelled in advance of due date. Membership dues are not deductible as charitable contributions for federal income tax purposes. However, MEMBERSHIP DUES ARE DEDUCTABLE as ordinary and necessary BUSINESS EXPENSES. This Investment Agreement must be signed by an authorized person with the member firm.
Name
Date