Join the Chamber

APPLICATION FOR MEMBERSHIP

D’IBERVILLE-ST. MARTIN AREA CHAMBER OF COMMERCE

To: Chairman

Membership Committee Chamber of Commerce

10491 Lemoyne Boulevard, Suite A,

D’Iberville, Ms. 39540

(228) 392-2293 Twitter: @dsmchamber

We make application for membership in the D’Iberville/St. Martin Area Chamber of Commerce.

(Check one of the following)

( ) Individual……...............………………………………….$50.00

( ) Small Business(Less than 5 employees)………$95.00

( ) Intermediate(5 to 25 employees)……….……..$175.00

( ) Large Firm(25 or more employees)…........….$275.00

Method of Payment: Annually

Please make check payable to D’Iberville/St. Martin Area Chamber of Commerce

Firm: __________________________________________ Phone: __________________________

Address: ______________________________________________ Fax: ______________________

Email: ____________________________________________________________________________

Web:________________________________ Facebook:_____________________________________

Kind of Business: ___________________________________________________________________

Member(s) Name:________________________________________________

I, we, are interested in the following projects or programs to be accomplished for the D’Iberville/St. Martin Area.

1._____________________________________________________________________

Committees I would like to serve on: Industrial: ___ Transportation: ____Legislation: ___Membership: ____ Education: ___ Recreation: ___

Signature of Applicant: ____________________________________ Date: _____________________

Please email dsm@dsmchamber.com or fax 1-888-269-9867 a copy of your completed application.