MEMBERSHIP INFORMATION
 
NAME/BUSINESS: ______________________________________________________________________________________
CONTACT/TITLE: ______________________________________________________________________________________
ADDRESS: ______________________________________________________________________________________
CITY: ______________________________________________________________________________________
STATE: ______________________________________________________________________________________
ZIP CODE: ______________________________________________________________________________________
TELEPHONE: ______________________________________________________________________________________
FAX: ______________________________________________________________________________________
   
MEMBERSHIP SCHEDULE
 
•Individuals/Retirees & Non-Profit Civic Organizations  
____ $50 per individual/organization  
•Retail/Service Businesses and Professionals  
____ 1-25 employees $100.00  
____ 26-50 employees $250.00  
____ Over 50 employees $500.00  
•Financial Institutions  
____ $25.00 per million in assets with maximum annual dues of $500.00  
•Industrial/Manufacturers  
____ $350.00 minimum, plus $5 per employee working in Pointe Coupee Parish with a maximum annual dues of $2,500.00  
•Out of Parish  
____ $150.00 - membership open to any category shown  
Contributions to Scholarship $____________  
 
Please return completed membership form with membership fees to:
 
The Greater Pointe Coupee Chamber of Commerce
 
P.O. Box 555, New Roads, LA 70760
 
THANK YOU FOR YOUR MEMBERSHIP!