Moulton Chamber of Commerce & Agriculture

MOULTON CHAMBER OF COMMERCE & AGRICULTURE

Business Name: ______

Individual/Couple/Owner Name: ______

Mailing Address: ______

Physical Address: ______

City/State/Zip: ______

Business/Home #: ______Fax #: ______

Cell #: ______

Email: ______Website: ______

Year Business Established: ______Hours of Operation: ______

Business Category (Please include a business card if applicable): □ Community/Civic Organization/Non-Profit □ Shopping/Retail □ Entertainment □ Real Estate □ Lodging □ Professional Services □ Dining & Catering □ Farm & Ranch □ Special Events □ Wholesale □ Education □ Other: ______

******************************************************************************** ********* 2014-2015 Membership Agreement & Dues Schedule

New Member ______Renewal ______□ $25.00 Individuals, Non-Profit Organizations, Civic Organizations □ $40.00 Family/Couple □ $75.00 Businesses

I am interested in: □ Becoming a Chamber Ambassador □ Other volunteer areas

P.O. Box 482 – Moulton, TX 77975 Phone: 361-596-7205 Website: www.moultontexas.com Email: [email protected] MOULTON CHAMBER OF COMMERCE & AGRICULTURE

Sponsoring an event: □ Jamboree □ Christmas in the Heart of Texas ______Signature Date

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Please make checks payable to: Moulton Chamber of Commerce Application is hereby made for membership in the Moulton Chamber of Commerce & Agriculture. This membership shall continue annually unless written notice is given. Membership renewals are billed annually in September.

The Mission of the Moulton Chamber of Commerce & Agriculture is to promote growth within our community.

P.O. Box 482 – Moulton, TX 77975 Phone: 361-596-7205 Website: www.moultontexas.com Email: [email protected]