SMOR Tri-Community Chamber of Commerce
Membership Application Form
Type of Membership Desired (Check One):
Business___ Non-Profit Org___ Personal____
NAME________________________________________________________
BUSINESS____________________________________________________
STREET ADDRESS____________________________________________________
MAILING ADDRESS____________________________________________________
CITY_________________________ STATE_____ ZIP CODE___________
TELEPHONE__________________________________________________
E-MAIL (Optional) ______________________________________________
FAX (Optional) _________________________________________________
SIGNATURE __________________________________________________
Please use the PRINT function on your browser, complete and mail this form and a Check or Money Order in the proper amount to:
SMOR Tri-Community Chamber of Commerce
P.O. Box 416
San Manuel, AZ 85631