Section 1: Membership Dues & Structure (check one below)

 Business: $150 (Your business information on www.campbellsport.org)

 Individual: $75 (Individuals that want to support our chamber)

 Non-profit: $25 (Your calendar of events listings posted on www.campbellsport.org)

Your Business/Individual/Non-Profit Name:

Section 3: Information (skip to Section 4 if you are renewing your membership with no changes)

Contact Name:

Address:

Phone: Fax:

e-mail: Website:

Section 4: Committee choice (must complete unless a Non-profit member)

Business members must be part of at least one committee. Please circle one below:

If you are interested in being a chairperson or co-chair of any committee, please let us know. Business members are asked to help with at least one event. Circle the activity your business is willing to help with. Chairpersons and co-chairs are needed for these events. If you are interested in being a Chair or Co-Chair, ask a member. If nothing is circled we‘ll assign you to an event

Please print this form and return with your payment to: Campbellsport Area Chamber of Commerce

PO Box 535, Campbellsport, WI 53010