Lebanon-Marion County Chamber of Commerce Membership Application

"Membership dues in the Chamber of Commerce may be tax deductible as an ordinary and necessary business expense. Dues paid to the Chamber are not a charitable tax deduction for federal income tax purposes. The Chamber is not a charity, but serves as an advocate organization for area business." IRS (Reg. 11.162-6)


Business Name:
Mailing Address:
Street Address:
City:		State:	Zip Code:
Telephone:
Fax:
Email:
Website:

	Key Representatives

Name:
Title:
Name:
Title:
Type of Business:
Annual Investment:	See dues schedule on membership information page.
# of Employees:	Full Time: Part Time:

	We now accept credit cards. Check one: Visa Master Card
	Credit Card #: Expiration Date:

	Please invoice me:

	If you are using Internet Explorer, when you click the submit button, a popup window (like the below image) will appear with a warning. The warning is to let you know that we will be receiving your email address when you send us your application. Please click yes to continue. After your information is processed, it is deleted for further protection. If you do not feel secure sending your credit card number via email, please call us at 270-692-9594 for further processing. WE WORK FOR YOU!!

You will receive an email notification as soon as we receive your application.