Bear Lake Rendezvous Chamber of Commerce Application

P.O. Box 55   Garden City, UT  84028  ||  435-946-2197

Please complete this form as much as possible. The information on this form is what we use to update
our records and our website. Mail or deliver this form to our office along with your membership dues.

 Business Name: _____________________________________________ Phone:____________________

 Physical Address:____________________________________________ Other Phone:_________________
 
 City___________________________________________
 State________  Zip __________

 Mailing Address:_____________________________________________ Fax:___________________

 City___________________________________________ State________  Zip __________

 Owner Name/Contact Name:_____________________________________________

 E-mail:  _____________________________________ Include email on website listing?  Yes  No

 Website Address:_________________________________________________________________

 Description of Business/Organization: (Maximum 25 words)

 _________________________________________________________________________________________

 _________________________________________________________________________________________

Would you or a representative from you business like to be on the Chamber Board?   Yes  No

 
Place a check mark up to two categories that best describes your business.
  Entertainment and Recreation   Lodging and RV Parks
  Government and Organizations   Retail Shopping
  Health, Medical, Fitness, Pharmacy   Restaurants
  Industries and Manufacturing   Realtors, Rentals and Title Companies
  Agriculture and Pets   Contractors, Builders, Construction
  Auto sales, repair, parts   Industry and Manufacturing
  Insurance Companies   Financial, Banks, ATMs
  Services and all others    

Membership Dues

Businesses $75.00  
Individual $50.00  
 
Number of Employees:_____ Amount Paid: $____________  Today's Date:___________