Antrim Chamber of Commerce

Membership Form

c/o Ericka Leonard, Antrim Chamber of Commerce Treasurer,

P.O. Box 157, Antrim, NH 03440-0157

Business Name_________________________________________

Contact_______________________________________________

Mailing Address________________________________________

City______________________ State_______ Zip__________

Phone______________________ Fax______________________

Email_______________________________________ Website________________________

Business Description___________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Please Sign Up to Help

[ ] Promotional Activities

[ ] Meeting Programs

[ ] Harvest Festival

[ ] Welcome Basket Program

[ ] Antrim Business Directory/Map

ACC Marketing Opportunities

[ ] Yes! I'd like a FREE web page on the ACC site -- a $250 value!

[ ] Yes! I'd like to be included in the Antrim Map & Directory (listing

is free, advertising extra)

[ ] Yes! I'd like to participate in the

Welcome Basket program

----------------------------------------------Tear Here------------------------------------------------

Antrim Chamber of Commerce

Receipt for Your Records

For Membership Dues, Antrim Chamber of Commerce $75.00

Date Paid: __________________

Thank you!

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