Please Fill in the following information and send form to complete your application:

Type of Membership: .. Full Membership Associate Membership Booster Member

Full Membership: Business Membership
Associate Membership: Business is already a member, you would also like to attend Chamber events.
Booster Membership: You don't have a business but want to support the Chamber

First Name:.................

Last Name:.................

Title:...........................

Company Name:........

Company Address:.....

City:...........................

State:......................... . Zip:

Type of Business: ......

Yellow Page Heading:

Email Address:...........

Web Site:..................

Business Phone: Cell Phone:

Fax:.................. Other:.......

Please direct Chamber communications to:

Name:.......................

Mailing Address:........

City, State, Zip:..........

Home Phone:.. ..Home Fax:.

Unless otherwise notified, the Discovery Bay Chamber will publish all or part
of the above information in its Directories.

I would like to be involved with:

Community Affairs ................. Marketing ................Membership

Ambassador ..................Chamber Events ................Newsletters

Note: After submitting this form your membership will be activated when the
Chamber receives payment. You may pay by Credit Card or by mailing a
check to the chamber.

Please select a payment method and then click "Send Form" below.

Payment Method: ...... Already Paid Check Credit Card

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