<p> MOULTON CHAMBER OF COMMERCE & AGRICULTURE</p><p>Business Name: ______</p><p>Individual/Couple/Owner Name: ______</p><p>Mailing Address: ______</p><p>Physical Address: ______</p><p>City/State/Zip: ______</p><p>Business/Home #: ______Fax #: ______</p><p>Cell #: ______</p><p>Email: ______Website: ______</p><p>Year Business Established: ______Hours of Operation: ______</p><p>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: ______</p><p>******************************************************************************** ********* 2014-2015 Membership Agreement & Dues Schedule</p><p>New Member ______Renewal ______□ $25.00 Individuals, Non-Profit Organizations, Civic Organizations □ $40.00 Family/Couple □ $75.00 Businesses</p><p>I am interested in: □ Becoming a Chamber Ambassador □ Other volunteer areas</p><p>P.O. Box 482 – Moulton, TX 77975 Phone: 361-596-7205 Website: www.moultontexas.com Email: [email protected] MOULTON CHAMBER OF COMMERCE & AGRICULTURE</p><p>Sponsoring an event: □ Jamboree □ Christmas in the Heart of Texas ______Signature Date</p><p>******************************************************************************** *********</p><p>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. </p><p>The Mission of the Moulton Chamber of Commerce & Agriculture is to promote growth within our community.</p><p>P.O. Box 482 – Moulton, TX 77975 Phone: 361-596-7205 Website: www.moultontexas.com Email: [email protected]</p>