Membership Application

CLASSIC: $100 / INDIVIDUAL: $50 / SENIOR CITIZEN(65+): $35 / NON-PROFIT-CHURCH-SCHOOL: $75

Membership: CLASSIC: $100 - NON-PROFIT/CHURCH/SCHOOL: $75 - INDIVIDUAL: $50 - SENIOR CITIZEN:(65+): $35*

Name of Company/Organization*

Type of Business

Business Address

Phone Number

Email*

Company Website Address

Organization Point Person - Phone Number and Email (If different from business)

Phone Number and Email (If different from business)

Name and Date*

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PLEASE MAIL YOUR PAYMENT TO SBA CHAMBER OF COMMERCE, PO BOX 284 KIOWA, KS 67070

Make Checks Payable to South Barber Area Chamber of Commerce

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