129 Court Street
P.O. Box 68
Ottawa, Ohio 45875

2010 MEMBERSHIP APPLICATION

Business or Organization__________________________________________________________________
Physical Address________________________________________________________________________
Mailing Address (if different) ______________________________________________________________
Phone_______________________Fax_____________________E-mail____________________________
Contact Name___________________________________________________# of Employees___________
Business Description_____________________________________________________________________
___________________________________________________________Date Joined_________________
Web address_____________________________________Would you like your website displayed with your listing in our website’s Member Directory?  (YES) (NO)
*(WE WISH TO BE LINKED TO YOUR WEBSITE IF YOU ARE LINKED TO OURS)
Would you like more information on the Chamber’s group health insurance programs  (YES)  (NO)   Would you like an evaluation by CCI, our workman’s compensation group rating program?  (YES) (NO)
    Risk #______________________________
Please provide a descriptive paragraph for use in marketing your business. Send to the above address or email to This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

Dues:    Full Business membership 2010        $185.00
Auxiliary membership            $50.00
    Retired membership            $50.00
    Non-profit membership (C-3 Corp.)    $100.00     
**Membership dues will be pro-rated quarterly for the first year.
Please make your check payable to the Ottawa Area Chamber of Commerce and mail to P.O. Box 68, Ottawa, OH  45875

Amount Enclosed $_______________
Check Attached______

Annual membership is from January 1 to December 31.  

MEMBERSHIP SIGNATURE:_______________________________________________________

    I understand that membership in the Ottawa Area Chamber of Commerce constitutes my express invitation or permission for the chamber to transmit by telephone facsimile machine to the number(s) I’ve provided above, e-mail or written materials, including but not limited to those relating to property, goods, services, events, meetings or notices, and the availability thereof.  I also understand that these will be published in the chamber’s membership directories, excluding those I’ve checked in the following box(es):
           ____  - Telephone number;  ____ -Fax number;  ____ -e-mail address.

Signed:_________________________________________________; Title:_________________________