North Penn Chamber of Commerce



Business / Organization
Type of Business
First Name
Last Name
Address
City
State
ZIP Code	-
E-mail Address
Day Phone
Evening Phone
Fax

Contact Person for Chamber
Number of Employees

Do you wish to offer discount or special service to other members? Yes No

List Committee Interests (If Applicable)

Annual Dues Investment (See Chart)
( Include one-time $25 Application Fee)
Primary Reason for Joining
Yes, I'm interested in advertising opportunities.
For payment, make check payable to: North Penn Chamber of Commerce 229 South Broad Street Lansdale, PA 19446 OR Call the Chamber at 215 362-9200 with credit card information. (Visa, Master card or Discover accepted)

229 South Broad Street
Lansdale, PA 19446
215 362-9200
Fax: 215-362-0393