Membership and Renewal Application

Membership and Renewal Application

Take advantage of the Yellow Spring Chamber's benefits, resources, and much more by becoming a member today!

Fill out the form below to submit your application online (required fields are marked by an asterisk *):

* New or Renewing Member:
New MemberRenewing Member

* Business or Organization Name:

* Physical Business Address:

Mailing Address (if different):

* City: * State: * Zip:

* Primary Contact:

* Phone:   Fax:

* Email Address:

Website (linked to chamber):

* Business Description:

Business Type:
Sole ProprietorPartnershipCorporationNon-ProfitOther
If other, please explain:

* Years in Operation:

* Number of Full-time Employees:

Why did you join the chamber?

Are you interested in being on a Chamber Committee?
yesno

Are you interested in volunteering for the Chamber?
yesno

Are you interested in learning more about Chamber Benefits?
yesno

Are you interested in being part of our Chamber Benefits Package by offering discounts to Chamber members?
yesno

  • Membership Renewal is One Year from the submission of this application; a delinquency of 45 days results in lapse of membership.
  • The Chamber uses e-mail as the preferred mode of communication with our members.

VOTING MEMBER: Business or Organization within the 45387 or 45316 zip codes.
NON-VOTING MEMBER: Individual Citizen or Business or Organization outside the 45387 or 45316 zip codes.

The Primary Contact Person is the Designated Voting Representative for Voting Members. Please designate an Authorized Voting Alternate.
Voting Alternate Name/Title:

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