Membership Application

To the Board of Directors

I/We agree to support the aims and objectives of the Chamber of Commerce, to promote the Commercial, Civic, Industrial and Agricultural interests of this area and further to preserve and enhance the operation of Canada's private and competitive enterprise based upon individual freedom and personal responsibility and initiative.

Membership applications will be processed upon receipt of your payment covering dues for one year.

Year beginning:
Company:
Operating Name:
Street Address:
Mailing Address:
City:
State/Province:
Postal Code:
Country:
Telephone:
FAX:
Email:
Website:
Contact Name:
Position:
What is your primary reason for joining the Chamber?
Form of Business:
Vendor's Permit No:
H.S.T No.:
If your company is a franchise, branch or subsidiary operation, please specify head office location, managers name, telephone number, etc.:
Number of employees including owners and managers:	Full Time: Part Time: Seasonal:
Number of years in business:
Description: (list products and/or services)
Have you ever been a member of the Chamber?
If Yes, when?
Do you belong to any other associations pertaining to your business?
If yes, please specify:
Membership provides a Buyers Guide Category listing. Please indicate the Category that best describes the nature of your product or service:

Additional Category listings are available at $20 each



Fee Type
Payment Method
Cardholder Name:
Card Number:
Card Expiry:
HST + $10 Ontario Chamber of Commerce Membership fee extra.

Application Terms
*Please note: The Chamber may wish to obtain information, be it credit or otherwise, as part of the application process and approval. All information shall be handled and secured as outlined in the Privacy Legislation and Policies. Membership is subject to approval by the Board of Directors. Completing an application is a pre-requisite for membership. All candidates admitted to membership shall undertake, in writing if required by the Board, to be governed by the by-laws, rules and regulations of the Chamber.

I Agree to the Application Terms before proceeding.

I am applying for Cornwall Chamber of Commerce membership based on the information provided above. With respect to this application, renewal or any changes made to my membership, I authorize you to collect, use and disclose to the Board of Directors information as permitted by law, such as credit information, for the purpose necessary to assess the application.

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