The Arlington Chamber of Commerce thanks the following sponsors:
 

Arlington Chamber of Commerce Membership Application
 

Questions or comments about the application? Let us know!
 
Company Information

Company Name:

Mailing Address:


City:


State:


Zip:


Phone:
(The number that you would like the public to call)


Fax:


E-Mail Address:
(The e-mail address that you would like the public to use)


Web Site:


 
Representatives' Information
   

Primary Representative Name:

Title:


Phone:
(If different from company number)


Email Address


Additional Representative:


Title:


Phone:
(If different from company number)


Email Address:


Please Complete the Following About your Company:

Membership Directory Listing (Yellow Pages Category). Please select one or more
categories from the dropdown menu below:

Please describe your business in 25 words or less. This enables the Chamber to properly refer your business to others and to promote your business in your monthly newsletter, The Arlingtonian. 

The Arlington Chamber of Commerce communicates with its member organizations via mail, fax, phone, and e-mail. These communications include the monthly newsletter, information about and invitations to upcoming events and other items of interest to our members. Your submission of this application indicates an agreement to receive such communications. In anticipation of the time when we will be able to send all of our communications by your preferred methods, please indicate below your preferences as well as any method of communications to which you object.

Mail

Fax

E-Mail

We prefer to receive our communications via:

We prefer not to receive:


Optional information Regarding Your Company
 (Check all that apply)

Woman-Owned

Minority-Owned

Home-Based

Not-for-profit Organization

Annual Investment:

Add:

One time processing fee [$25.00]

TOTAL:

Number of full-time employees with an Arlington mailing address


Please choose one of the following payment options:

Cash (if using this option, please mail payment to the Chamber address below; your application will be considered upon receipt of payment)

Check (if using this option, please make check payable to "Arlington Chamber of Commerce" and mail to the Chamber address below; your application will be considered upon receipt of payment)

Credit Card (VISA, MasterCard, American Express, Discover)

(The transmission of this document is NOT over a secured line. The Chamber office will call you for your credit card type, number, and expiration date. Do NOT enter this information on this form.)

Your company may choose to pay dues through an automatic bank debit from a checking account. Monthly membership dues investment is authorized for a twelve (12) month period and will renew automatically on the annual anniversary at the then current rate. If you choose this option, please submit a completed authorization form.

Why did you join the Chamber? (please check all that apply)

Networking opportunities

Advertising/promotional opportunities

Legislative representation

Community programs/involvement

Member discounts

Other (please specify)

An Arlingtonian subscription rate of $4 per Chamber member is collected as part of the annual dues investment. The Omnibus Budget Reconciliation Act of 1993 prohibits you from deducting, for federal income tax purposes, the portion of your membership dues investment that is allocable to the lobbying activities of this organization. The Arlington Chamber of Commerce reasonably estimates that 1% of your membership dues investment is allocable to lobbying expenditures, and therefore 1% of your dues is not deductible as a business expense.

Referred by:

Company:


Thank You.

Arlington Chamber of Commerce
2009 14th Street, North, Suite 111
Arlington, Virginia 22201
 
 

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