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HITCHCOCK CHAMBER OF COMMERCE

Renewal Membership Application

Date_________________________________________________________________________

Member Name_________________________________________________________________
(Business or Individual)

Contact Person_________________________________________________________________

Mailing Address____________________________ City, State, Zip________________________

Street Address_____________________________ City, State, Zip________________________

Phone No.( )________________ Fax No.( )_____________ E-mail ___________________

Number of Employees_____ _____ Type of Business_________________________________
Full-time Part-time

Annual Renewal Fee Schedule:
Non Profit Organizations $ 35.00 Small Business $45.00
Association/Corporation (1-5 Employees) $100.00 Individual $ 20.00
Association/Corporation (6-24 Employees) $150.00 Couple $35.00
Association/Corporation (25 + Employees) $200.00

Contribution to our American Flag drive $ 20.00

AMOUNT ENCLOSED_______________

Please return this completed form and payment to:
Hitchcock Chamber of Commerce
P.O. Box 389
Hitchcock, Texas 77563