Covington-Tipton County Chamber of Commerce
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Covington-Tipton County Chamber of Commerce Membership Application
Date:______
Company Name:______
Street Address:______
Mailing Address:______City:______State:______Zip Code:______
E-mail:______
Website:______
Phone:______Fax:______
Business Owner:______Contact Person 1:______
Billing Representative:______Contact Person 2:______
Briefly describe business, if you are a retail business, please list what sets your company apart:______
______
We provide blast e-mail service for all of our members. If you wish to receive emails updating you on the latest Chamber activities and member information, please list ALL e-mail addresses of employees who wish to receive this service.
Name:______E-mail:______
Name:______E-mail:______
Name:______E-mail:______
Name:______E-mail:______
Do you wish to receive blast faxes?______YES______NO
Do you wish to receive blast e-mails______YES______NO
Do you wish to be added the the Chamber Gift Certificate known as “Chamber Bucks”? ______YES______NO