Copiague Chamber of Commerce
 P.O. Box 8 - Copiague NY 11726 - (631)226-2956
eMail: SalPLS@aol.com --- WebSite: www.CopiagueChamber.org
Annual Membership Application for 2008

Date:__________

Name of Proposed Member /Organization:__________________________________________________
Name of Primary Contact/Delegate________________________________________
Name of Alternate Contact/Delegate_______________________________________
Street Address:________________________________________________________
City: ___________________________________ State: ___ Zip:________-________
Telephones: Bus:_________________________ Fax: _________________________
Cell: ________________________________      Pgr: _________________________
Home Telephone: _____________________________________________________
Email:_________________________________ WebSite:_______________________
Referred By___________________________________________________________
Type of Business /(Organization)__________________________________________
Additional Remarks: ____________________________________________________
_____________________________________________________________________
General Purpose The Copiague Chamber of Commerce is an alliance of businesses, residents and organizations in Copiague, determined to improve the quality of life and general business environment in Copiague. This is carried out via a networking process among all its members.
Annual Dues (due each January 1st) Regular Member____________________________________________$84.00
Associate Member___________________________________________$24.00
Individual Member__________________________________________$24.00
Elected Official_____________________________________________$24.00
Regular membership includes "full voting rights" as well as the opportunity to take out "business card sized ads" in the Chamber Newsletter. No other "class of membership" is accorded these priviledges and benefits
Associate membership is available to civic, religious and other non-profit organizations.
Individual membership is available to any person ("private citizen") interested in the welfare of Copiague and its Chamber.
Elected Official is a "membership class" available to any elected official, at any level, who expresses an interest in the welfare of Copiague and its Chamber.
Application must be accompanied by full payment of annual dues (pro-rated the "first year"). Failure to do so will cause automatic rejection.

____________________________________ agrees, in applying for membership, to honor and be bound
(Please print the name of the applicant)
by the rules, purposes and By-laws of the Copiague Chamber of Commerce.

_________________________________________
Signature for the applicant