Membership Form

Membership & Web Directory Information
Name:
Contact:
Address:

Phone:
Fax:
E-Mail:
Web Address:
Number of Employees:	Full-Time:	Part-Time:
*Category/Categories under which you wish to be listed:


*NOTE: Please use a previous directory as your guide. If you do not see the appropriate category, we will create a new one for you. We want to make sure your business appears under all categories that will help us sell your products and/or services.


	Greater Salem Chamber of Commerce • 615 West Main Street • Salem, Illinois 62881 Ph: (618) 548-3010 • Fx: (618) 548-3014 • E-Mail: visitus@salemilchamber.com
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