Membership Application

This application is no longer valid. Please utilize the new online membership form here.
COMPANY INFORMATION (Please complete all boxes.)
Full Company Name:
Year Established:
Street Address:
City:
State:
Zip:
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip:
Telephone No.:
Fax No.:
Website:
Email:
No. of Full-Time Employees:
No. of Part-Time Employees:
Check (optional) if you are a:
Woman-owned business women-owned

Minority-owned business
Race/Ethnicity:
CONTACT INFORMATION
Main Representative
Salutation:
First Name:
Last Name:
Title:
Email:
AREAS OF INTEREST
Areas of Interest Benefit Programs
Economic Development
I would like to be enrolled in the Office Depot Savings Program.
I would like to receive a quote on workers comp group pooling.
Networking Opportunities
Legislative Advocacy
MEMBERSHIP REFERENCE GUIDE LISTING
PAYMENT INFORMATION
There are several membership levels available. Please refer to the chart below for Base Dues.


Place your payment amount on the line below.
Membership Fee:          $
Credit Card Type
Credit Card Information:       
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card Address 2
Credit Card City
Credit Card State
Credit Card Zip
Credit Card ZipExt
Credit Card Phone Number
Credit Card Country
Credit Card Email Address

Dues to the Toledo Regional Chamber of Commerce are not deductible as a charitable contribution but may be deductible as an ordinary and necessary business expense. A portion of the dues, however, is not deductible as an ordinary and necessary business expense to the extent that the Toledo Regional Chamber of Commerce engages in state and/or federal lobbying. The non-deductible portion for this year is five percent.


I understand that chamber membership does not guarantee acceptance into any Toledo Regional Chamber of Commerce benefit program. I further understand that the chamber has a "no refund" policy. All applications are subject to approval by the Toledo Regional Chamber of Commerce Board of Trustees.

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