New Member Application Antigonish Chamber of Commerce 21B James St. Antigonish, NS B2G 1R6 Tel. 902‐863‐6308 Fax. 902‐863‐2656 www.antigonishchamber.com Upon receiving this application with payment; your new member application will proceed to the Chamber Board for Approval & Processing by Chamber Staff. Business Name: Business Phone: Business Fax: Civic Address (Street, Town, Postal Code): Mailing Address (only if different from Civic Address): Website: Primary Contact: Phone: Email: Additional Contacts: We encourage you to have Chamber News sent to other individuals within your business. There is no limit to who receives Chamber News as long as they’re a current employee. If you wish to add additional contacts, please complete below. If required, please attach additional contacts. Name: Name: Email: Email: Employees: Your membership category is based upon the number of full‐time and part‐time employees. A single part‐ time employee is equivalent to ½ full‐time employee. E.G. 2 full‐time + 2 part‐time = 3 employees. Please round up to select category. Categories: Individual Member (Senior/Student) $66.13 Self / 1 – 4 Employees $138.86 Full‐time: ________ 5 – 20 Employees $198.38 Part‐time:________ Seasonal: ________ Over 20 Employees $330.63 Number of Employees: (HST Included) Select from below the Primary Category that best describes your business (only circle one): Accommodations Accounting & Bookkeeping Agriculture Aquaculture and Seafood Products & Services Architectural & Engineering Arts & Culture Automotive Dealers, Rental, Services & Suppliers Business Consultants Childcare & Education Community Agencies Construction & Contractors Economic Development Electronics & Electric Environmental Industries Financial Services & Banking Food & Beverage Fuel Services Funeral Services Government Groceries Hairstyling & Esthetics Health & Wellness HR & Employment Services Insurance Lawyers & Legal Services Signature: Manufacturing & Processing Marketing & Advertising Media & Communications Medical, Dental, & Optical Print & Design Real Estate Recreation & Leisure Retail Tech Sales, Services, & Support Individual Member Other (Specify) ________________________ Date: OFFICE USE ONLY □ Simply □ MailChimp □ Online Directory □ Neon □ Welcome Email □ New Member Package Date Received: Signed: