Membership Form

Name of Business or Individual *

Size of Business/ Dues Structure *

Individual-$50 Non-Profit-$100 X-Small (1-2 Employees)-$100 Small (3-6 Employees)-$150 Medium (7-24 Employees)-$250 Large (25+ Employees)-$350 Solo Professionals $250 Group Professionals $550

We have some tremendous supporters who have joined above and beyond their business size level to further support our organization. These members are listed as Platinum members. Contact our office for more information on how to become a Platinum Member

Name of contact person in your business *

First Name Last Name

Phone Number *

Area Code Phone Number

Mailing and Physical Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Email *

example@example.com

Belleville Chamber & Main Street is always looking for new volunteers for committees as well as single events and other activities. Please indicate where you would like ot help.

Committees and Events

Ag Committee Board of Directors Car Show Design Committee Promotion/Retail Committee Rocky Pond Christmas Economic Restructuring

Enter coupon code at check out

(Associate)-for out of town members

(New)-for new members

Must join at $150 or above for Grant Eligibility

Membership Dues *

Individual $ 50.00

Non-Profit $ 100.00

X-Small $ 100.00

Small $ 150.00

Medium $ 250.00

Large $ 350.00

Solo Professionals $ 250.00

Group Professionals $ 550.00

Enter coupon

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code