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FOR OFFICE USE ONLY Payment Type: _________________ CM Entered By: ___________________ CM Invoice #: __________________ CC Captured By: _________________ Membership Application Company Name: Number of Employees: Year Established: Physical Address: City: State: Zip: Billing Address: City: State: Zip: Phone: _________ FAX: _________ Company Email: Website: Contact Name: Title: Contact Email: ________________________________________________ Contact Phone: ______________________ Cell: ____________________ Home Address (if in Santa Barbara) __________________________________ Additional Contacts in Company for Chamber Communications: Name: _________________________________________________________ Email: __________________________________________________________ Name: _________________________________________________________ Email: __________________________________________________________ Our Mission: To enhance and promote the regional economic environment through support of our members and collaboration with business, government and community resources. The Chamber of Commerce of the Santa Barbara Region 104 W. Anapamu Street, Ste. A – Santa Barbara, CA 93101 805/965-3023 – Fax 805/966-5954 – www.SBChamber.org Unpublished Information Method of Payment Check Enclosed Charge My Card Name (as it appears on card): Address (where the statements are mailed): Street: City: State: Zip: Card #: Expiration Date: Security Code: Membership dues in The Chamber of the Santa Barbara Region are not tax deductible as charitable contributions for federal income tax purposes, but may be deductible as ordinary and necessary business expenses. A portion of the dues is not deductible as an ordinary and necessary business expense to the extent that the Chamber engages in state or federal lobbying. The nondeductible portion of the dues is two percent (2%). Santa Barbara Federal Tax I.D.: 95-1190650. By signing this application, you are hereby establishing a business relationship with the Chamber of Commerce and authorizing the Chamber of Commerce to communicate with you via fax, email or other means, either directly or through a contracted and/or authorized agent. These communications will include event notifications, promotional opportunities and other promotions or solicitations, which may be in the form of advertisements that the Chamber feels are beneficial to its membership. Please do not send event, promotional, or advertising information. Signature: Date: Investment Schedule/ Member Features and Benefits Please check the Membership Tier of Your Choice ☐ Business Leaders Council Annual Investment $2,250 ☐ Business Leaders Council Colleague $195 ☐ Business Leaders Council Hospitality $295 ☐ Entrepreneur Membership Annual Investment $1,100 ☐ Executive Membership Annual Investment $675 ☐ Hospitality Membership Annual Investment $525 ☐ Business Membership Annual Investment $395 Sub Total: $______________ ☐ Additional Link(s) (+$75 per link) + $ _____________ ☐ Processing Fee (one-time only fee) + $ 45 Total: $ ______________ Five Core Competencies of Your Chamber ☐ Creating a Strong Economy ☐ Promoting the Community ☐ Representing Business Interest with Government ☐ Provide Networking Opportunities ☐ Seeking Pro-Business Candidates Please Check Your Interests Directory Listings: (where to list your business in our Directories) 1) ____________________(inc.) 3) ___________________($75) 2) ____________________($75) 4) ___________________($75)
