Membership Investment Application

Business Name:______________________________________________

Business Lic. No:___________________________________________

Street Address:_____________________________________________

Mailing Address:____________________________________________

City, State, Zip:___________________________________________

Business E-Mail:____________________________________________

Personal E-Mail:____________________________________________

Web Site:___________________________________________________

Business Phone:_________________________

Cell Number:____________________________

Fax:____________________________________

Owner:__________________________________

Alt. Contact:___________________________

Would you like to schedule a Ribbon Cutting/Grand Opening/Mixer/ Business Spotlight Interview?

Yes________           No________

Signature:__________________________________________________

Date:_______________  Amount Paid:__________________________

Paid By: Check:________  Cash:__________     CC:___________

Please mail to the Dayton Area Chamber of Commerce, PO Box 2408, Dayton, NV 89403.  Or bring to the office located in the Greater NV Credit Union during business hours: Wed., Thurs., & Fridays, 9:30 am to 2:30 pm. Please call 775-246-7909 prior to coming to the office as our Executive Director is often out talking with local businesses, etc.