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Orange Chamber of Commerce
Orange, New Jersey

ORANGE CHAMBER OF COMMERCE
MEMBERSHIP APPLICATION
Please Print Out this Form
Mail or Fax the completed form to our office.
The undersigned does hereby submit application for membership in the Orange Chamber of Commerce. The undersigned warrants that he/she is a bona-fide business in good standing within the State of New Jersey and agrees to abide by the Constitution and By-Laws of the Orange Chamber of Commerce, including payment of annual dues in the amount of $125 or $250, according to the scale below.

Contact Name
___________________________________________________

Business
___________________________________________________

Address
___________________________________________________

City ______________________________ State _________

Zip Code ___________________

Phone _____________________________________________

Fax _______________________________________________

Email Address
___________________________________________________

Type of Business
___________________________________________________

Annual Dues:
_____ $125 for firms having 24 or less full-time employees
(2 part-time = 1 full-time)
_____ $250 for firms having 25 or more full-time employees
(2 part-time = 1 full-time)

Signature
___________________________________________________

Dues renewable January, 2011. Payment by check or major credit card accepted. Make check payable to "ORANGE CHAMBER OF COMMERCE" and mail with print-out of this form to P.O. Box 1178, Orange, NJ 07051. For credit card payment, call (973) 676-8725.