joinchamber

Coudersport Area Chamber of Commerce

Membership Application

Please use your tab key or mouse to go between fields. Do not use your enter or return keys before the form is complete.

Please provide the following contact information:

Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Work Phone

FAX

E-mail

URL

Choose one of the following options:

New Membership
Renew Existing Membership

Choose one of the following options:

Type of Membership

Individual Membership for Non-Professional $ 35.00

Non-Profit Organization, Governmental Agency $ 50.00

Business & Professional

Introductory Rate for New Members $50.00

Businesses with 1 – 10 Employees $110.00

Businesses with 11 – 25 Employees $175.00

Businesses with 26 – 50 Employees $250.00

Businesses with 51 – 500 Employees $350.00

Businesses with 501 or more Employees $1,500.00

Employee is defined as one who works a full-time schedule.

Please send check Made payable to CACOC (Coudersport Area Chamber of Commerce) to

P.O. Box 261, Coudersport, PA 16915

(814) 274-8165

Return to Main Page

Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail
URL