Application

Union County Chamber of Commerce Membership Application

Business Name

Owner/CEO Name

Business Contacts

E-mail Addresses*

Address

Number of Employees
Full Time (Equivalent)
Part Time

City

State	Zip Code

Phone Number

Chamber Benefits
(Please check if you are/or plan to receive any of the following benefits available to you as a member):

Fax Number

Toll Free Number

Web Site Address

Type of Business

Normal Business Hours

(Please specify Monday - Sunday and any additional comments)

Description of Business

Please enter the two words you see in the picture

*Required Fields