Name of Business/Organization:_________________________________________




	
Mailing Address:_______________________________________________________




	
Contact Person:________________________________________________________




	
Phone Number:__________________________________________________________




	
Current Email:_________________________________________________________




	
Business Website:______________________________________________________




	
Business Fax Number(for website):______________________________________




	
Description of your Business & Store Hours(for website):


	_______________________________________________________________________




	
Please look at the 2006 schedule on the website, which event(s) would

	you be most interested in helping with?


	_______________________________________________________________________




	
What are your suggestions for activities, promotions or events you

	would like to see the Chamber sponsor?


	_______________________________________________________________________




	
Other comments:________________________________________________________





	


	Please return your check with the Membership Form to the

	Chamber of Commerce Office, P.O. Box 160, Gordon, NE 69343

	For more information call the Chamber Office 308-282-0730.