Join the Chamber

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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 

Email: dsm@dsmchamber.com 

(228) 392-2293

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:________________________________

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: _____________________