Membership Application 2020

Important Note: While we continue the transition to our new database, membership applications are still being processed manually and your membership may not be added to the database the same day. Please wait until you receive notification that your membership application has been processed before you register for an event to ensure you receive member pricing.

Business/Contact Information

Legal Corporate Name:

Business Name:

Date Established:

Name Prefix :

First Name:

Last Name:

Title :

Mailing Address:

City:

State:

Zip:

Phone:

Cell Phone (optional):

Fax:

Email:

Business Website:

Business Category:

# Full Time Employees:

# Part Time Employees:
(each part time employee is counted as one half employee)

How did you hear about us?

Reason(s) you are joining the chamber:

Dayton Area Chamber Representative:

2020 Dues Investment

*Get Chamber Plus details at DaytonChamber.org/join
Employee Count	Chamber Plus Dues*	Basic Dues
1 - 9	$610	$470
10 - 14	$705	$565
15 - 29	$775	$635
30 - 49	$990	$850
50 - 99	$1285	$1145
100 - 149	$1870	$1730
150 - 199	$2315	$2175
200 - 299	$3000	$2860

Member Savings Programs

Click here to view details for each program
- CareWorks Absence Management - CareWorks Medical Management - CareWorksComp Workers' Compensation - EAP Plus+ Employee Assistance - Healthcare Participation - IGS Energy Discount - Infintech Merchant Services - Office Depot Office Product Discounts - Speedway Gas Cards

Billing Contact Information

Same as business information: (Skip this section if checked)

Billing Contact:

Billing Address:

Billing City:

Billing State:

Billing Zip:

Billing Phone:

Billing Fax:

Billing Email (Chamber use only):

Payment Information

I've reviewed the cost and benefits and choose the Chamber Plus Membership

Dues: $
You must enter the number of full and part time employees in the Business Information section for your dues to be calculated. If you have 300 or more employees or have questions, please call 937-226-1444 and ask to speak with a Member Development Representative.

Application Fee: $

Total Investment: $

Payment Method: VISA MasterCard AMEX

Card Number:

Expiration Date:

Security Code: Note: Your credit card will not be charged until your application information has been verified.

Note: In compliance with federal law, 90.05% of your dues are deductible as a business expense; 9.95% is non-deductible as it supports lobbying activities of the chamber.

Submit Your Application

By submission of this form you are authorizing the charge for the membership fees to your credit card. If the amount submitted for membership dues or associated fees was incorrect or the total was calculated incorrectly, the chamber will contact you so you can be billed for the correct amount. If you have any questions or concerns prior to submission, please call 937-226-1444 and ask to speak with a Member Development Representative.

Membership in the Dayton Area Chamber of Commerce constitutes express permission for the chamber to transmit by fax to the numbers provided, through e-mail or written materials, including but not limited to those relating to goods, services, meetings or notices thereof. By submission you indicate your understanding of the above and request for membership.