UA Chamber - Member Application

Complete the following information and click 'Submit'
You may also download an application here and mail or fax to our office.

Chamber Membership Application

Organization/Company*
Parent Company

Primary Contact

Name*		Phone*
Title		Fax
Email
Web site

Preferred Method of Communication

Mailing Address

Address 1*		Address 2
City*		State*
		Zip*

Billing Address - (if different)

Address 1		Address 2
City		State
		Zip

Company Information

Industry

Employee Count:
Full Time:		Part Time:

Web Search Keywords - (Maximum Six)


Membership Information

	*NOTE: Includes one time Registration Fee of $25.00
Type

Decline Free Plaque

Chamber Committee Opportunities
Please select areas of interest

	Business Advocacy Committee (BAC) For members interested in public policy and legislation
	Revitalizing Retail Taskforce Focus on revitalizing and promoting local retail.
	Public Relations Utilize your marketing skills to raise community awareness and promote the chamber, its events, and programs.
	Ambassador Committee Stay in contact with fellow members, help host Member breakfasts, networking events, ribbon cuttings, and more.
	Finance Taskforce Bring your talent with numbers to help evaluate and create the Chamber budgets.
	Older Adult Resource Group Sponsors senior-focused educational events.
	Taste of UA Join the group that brings you one of the most exciting and powerful events of the year.
	Golf Classic Join the group that brings you one of the most fun events of the year.
	Program Committee Do you have ideas for new programs and new ideas for existing programs.