Join The Gas City Chamber
Firm Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Type of Business {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Contact Person {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Contact Person's Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Phsyical Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Business Telephone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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FAX Number {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Website {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Number of full-time or full-time equivalent employees (two part-time employees equal one full-time employee) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Membership Agreement
My firm is making a formal application to become an active member of the Gas City Area Chamber of Commerce. Please invoice my business as per the appropraite investment schedule.
I understand the information I have submitted will be published unless otherwise noted.
Signature {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
Your Title {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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Today's Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }
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