The Island Pond Chamber of Commerce
PO Box 255
Island Pond, Vermont 05846

Membership Application/Renewal Invoice

Please register my business in the Island Pond Chamber of Commerce in the following category.

[ ] Business Membership $75.00
[ ] Business Membership With Clickable Text Link $85.00
[ ] Business Membership With Clickable Logo/Banner On Website $100.00
[ ] Friend of the Chamber $25, non-business owners

Contact Persons Name:________________________________________
Business Name: _______________________________________
Street Address: ________________________________________
Mailing Address: ________________________________________
City, State, Zip: ________________________________________
Email Address: ________________________________________
Website URL: ________________________________________
Phone Number:_____________________Fax Number:______________
Services Offered: ________________________________________
Authorized Signature: ________________________________________

Mail to:
Island Pond Chamber of Commerce
PO Box 255
Island Pond, VT 05846