Cortez Area Chamber of Commerce

p. o. Box 968 ~ 928 East Main Street ~ Cortez, CO. 81321

(970) 565-3414 ~ fax (970) 565-8373

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Membership Application

Any business, organization or individual that desires to work with others to improve our community is eligible for membership.  Membership is not dependent on race, gender, economic status, health status, or any other restriction. The Cortez Area Chamber of Commerce does not make health insurance coverage offered through the association available other than in connection with someone who is a member of the association

Business Contact:        ________________________________________________

Business Name:           ________________________________________________

(Required)

Street Address:           ________________________________________________

Mailing Address:        _______________________________________________

City/State/Zip:             ________________________________________________

Phone:                         ________________________________________________

Fax:                             _______________________________________________

Email:                         ________________________________________________

Web Address:             _______________________________________________

Number of Employees:  (Full time equivalents example:  2 employees working 20 hours per week each are only one full time equivalent)  _______________________

Description of Services:  25 words or less, which will be used for your listing on the Chamber website:    

Signature/Date:          _________________________________________________

Dues: