APPLICATION FOR MEMBERSHIP
                                                                   Greater Severna Park Chamber of Commerce
                                                                             www.severnaparkchamber.com
                                                                      1 Holly Avenue, Severna Park, MD  21146
                                                                               Telephone. 410-647-3900
                                                                                      Fax 410-647-3999  

DATE______________________NUMBER OF EMPLOYEES___________________________

BUSINESS NAME______________________________________________________________

ADDRESS_______________________________________________CITY_________________

STATE_______ZIP_____________TELE._______________________FAX________________

EMAIL_________________________________WEBSITE______________________________

DESIGNATED CONTACT:_____________________________Who referred you to the
Chamber?______________________________________________________________________

Description of Business…what do you offer?  What makes your business stand out in its
field?  Supply the type of detail you’d like conveyed to the membership in our next newsletter to introduce you as a new Chamber of Commerce
member (you can add an attachment if needed).
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Payment enclosed (annual dues plus $25.00 one-time processing fee) $_______________
My VISA/MC/AMEX# is_________________________Exp._______3-Digit Code____

Note:  Membership may be tax deductible as an ordinary, necessary business expense.  Membership investment paid to the Chamber is not a charitable
deduction for federal income tax purposes.

                                                                   MEMBERSHIP INVESTMENT STRUCTURE
                                                           Please include a one-time processing fee of $25.00
                                                                      NON-PROFIT ASSOCIATION - $110.00
                                                                           *ASSOCIATE MEMBER - $70.00
                                   *someone, such as a retired person, who does not qualify for a business membership.
                                                                           **SOLE PROPRIETOR - $140.00
                                                                   **businesses with no employees, “one-man shops”
                                                                1-4 Employees - $155.00    -    5-9 Employees $215.00
                                                             10-24 Employees - $275.00    -     25+ Employees $315.00
                                                                                   50+ Employees $400.00

                                                        Note:  Part-time employees are treated as ½ of a full-time employee.  
                            Your annual investment for a 12-month period is from the month you join until your anniversary date.