Bouse Chamber of Commerce membership application
Print this form, fill it out and mail it or bring it into the chamber office with your check or money order. Do not mail cash. The chamber is behind the historic Assay Office / Bouse Museum at
44362 E. Main Street, east of Hwy 72.

Bouse Chamber of Commerce
P. O. Box 817

Bouse, AZ 85325-0817

Name_______________________________________ Date__________________________
Business Name_______________________________ Business type__________________
Mailing Address______________________________ Home Address__________________
City, State, Zip_______________________________ Web site______________________
Telephone___________________________________ e-mail_________________________
_____ Individual Annual Membership $10 Chamber memberships are renewable annually and expire December 31.
_____ Business Annual Membership $25 *
* Business membership includes a listing on the Bouse Chamber's Web site. Keep a copy of this form for your records. Bouse Chamber of Commerce is a 501(c) (3) non-profit organization.
_____ Would you like to volunteer? Doing what?___ ______________________________



form last updated

December 30, 2010