716-285-9141
Check any of the following promotional and involvement opportunities you may be interested in: Event SponsorshipOnline AdvertisingNewsletter AdvertisingCommittee Involvement
Company Name:
Category of Business:
Address 1:
Address 2:
City:
State:
Zip:
Phone:
Fax:
Email:
Website:
Company Representative:
Title:
Additional Contact(s) -
Non-Profit?: YesNo
Number of full time employees:
Number of part time employees:
Business Description:
Date Business Established:
Sponsor:
Interested In: Health InsuranceEnergy ServiceDental InsuranceTelecommunication Service
Member Investment Information: One representative is included with each membership Businesses - 1-10 Employees •••••• $225 11+ employees •••••• add $3 per full time employee
Hotel & Motel •••••• $225 plus $2 per room One company representative is included with each membership, plus $2 per room and $100 per restaurant and/or banquet facility.
Not-for-Profit Corporations •••••• $180
Banks, Utilities, Colleges/Universities, Media, Health Care Facilities •••••• Negotiated Rate
Additional Business Membership •••••• $100 Individuals whose primary business is an Active Member may enroll an additional wholly-owned business for an annual fee of $100 per business; one representative with membership.
SPONSOR OPPORTUNITIES AVAILABLE •••••• Inquire
Associate Canadian Membership •••••• $75
Application Fee: Add $20
Voluntary PAC (Not required - donation to political action committee is voluntary) Add $75 YesNo
Total Amount:
Please submit this form and send your check to: NIAGARA USA CHAMBER 6311 Inducon Corporate Drive Sanborn, NY 14132
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