| ANNUAL DUES: $240.00 TOTAL DUE:$240.00 2nd BUSINESS & INDV.: $100.00 |
| Please print out page, complete form below, make check payable and mail to: |
Ocean City Regional Chamber of Commerce |
| Company Name:_________________________________________________________ |
| Contact Name:___________________________________________________________ |
| Phone:____________________________Fax:__________________________________ |
| E-mail:____________________________Website:_______________________________ |
| Mailing Address:__________________________________________________________ |
| Street Address (if different)__________________________________________________ |
| City:______________________State:________________Zip:______________________ |
| Type of Business:____________________________# Full-Time Emp.________________ |
| Hours/Dates of Operation:___________________________________________________ |
| Authorized Signature:__________________________ Date:________________________ |
| Referred By:_____________________________________________________________ |
| Payment Method: Check Enclosed___ Visa___ MasterCard___ |
| Card Number:____________________________________Exp. Date:________________ |
| Name: on Card:_______________________ Signature:____________________________ |
| I'm interested in: |
| ___Mailing Labels ___Piggyack Mailer ___Brochures @ Info Center ___Visitors Guide Advertising |