Go to Membership Information Page

To complete form just print it out, complete, and mail to the "Return To" address noted - Thank you!

2008 Membership Remittance
	Friends & Supporters	$25
	Non-Profit Organization	$50
Business Membership Dues Schedule:
No. of Employees		Dues Range
	Home-Based Business	$50
	1 - 2	$100 - $200
	3 - 10	$150 - $300
	11 - 20	$225 - $400
	21 - 30	$275 - $500
	31 - 40	$325 - $600
	41 - 50	$400 - $700
	51 - 100	$600 - $900
	101 plus	$1100 - $1500
Total:

Contact Information

Contact Person: ________________________________________________________________

Company: ____________________________________________________________________

Location/Address: ______________________________________________________________

P.O. Box: _____________________________________________________________________

City: _________________________________________________________________________

State: __________________________________________ZIP Code: _____________________

Phone: _______________________________________________________________________

Fax: _________________________________________________________________________

E-Mail: ______________________________________________________________________

WebSite: _____________________________________________________________________

Signature:_____________________________________________________________________

Date: ________________________________________________________________________

Return form and payment to:
Dodgeville Area Chamber of Commerce
338 N. Iowa St.
Dodgeville, WI 53533