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.
• Refunds for membership fees are not available. If you have any questions about the charges, please contact Karen Wintrow at 937.767.2686 or kwintrow@yschamber.org.
• The Chamber uses e-mail as the preferred mode of communication with our members.

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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