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Membership Application Member Directory 2016 - 2017


I hereby make an application for membership in the Assiniboia Chamber of Commerce at $__________+ GST per annum for the year 2016-17 to be automatically renewed each year on the 1st


day of January, at such rates as maybe approved annually by the


Board of Directors. Business Name ________________________________________________________ Mailing Address ________________________________________________________ City ____________________________________ Postal Code _________________ Phone _______________________________________________________________ Fax __________________________________________________________________ Website ______________________________________________________________ Category for Directory ___________________________________________________ Name(s) of Representatives: (1) Primary ____________________________ E-Mail _________________________ (2) Secondary _________________________ E-Mail _________________________


Referred by: __________________________________________________________  I/We agree to be contacted via email by the Chamber or any of its members. My expectations upon joining the Assiniboia Chamber of Commerce: ___________________________________________________________________ ___________________________________________________________________


___________________________________________________________________ Membership 2016-17


Fee


Up to 150 employees, one representative Over 150 employees, one representative Additional Representatives


$200.00 $325.00 $35.00


GST


$10.00 $14.75 $1.75


Total


$210.00 $341.25 $36.75


Please Note: Rates are subject to change, membership fees are billed annually for January to December. Mid-year membership fees will be adjusted accordingly. This ap- plication is subject to approval of the Board of Directors in accordance with Assiniboia Chamber By-Law #7. Any resignation must be made in writing


___________________________________________________________________ Signature


Date: RETURN TO:


Assiniboia Chamber of Commerce, Box 42122 RPO Ferry Road, Winnipeg MB R3J 3X7 OR Fax: 204-774-4201


OR Application available online: www.assiniboiachamber.ca www.assiniboiachamber.ca • Assiniboia Chamber of Commerce 2016 - 2017 13





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