Membership Application

Instructions

Please complete the application form in full. Email Director@midwaychamber.org with any questions.

Select An Option

General Membership $175 Annually

Home Based Business $75 Annually

Not For Profit $75 Annually

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

Midway Chamber of Commerce