Raritan Area Chamber of Commerce, Inc.
P. O. Box 236
Raritan, New Jersey 08869

Membership Registration Form  

Membership in the RACC is open to businesses, retailers, professional offices and 
industries located in Raritan, New Jersey or in the immediately surrounding area.

Please complete this form in its entirety, sign, date and return it to the above 
address or bring it to the next meeting on May 15th.  PLEASE PRINT CLEARLY OR TYPE.
Please remember to enclose your dues payment if you plan on becoming a member of 
the Chamber.  Checks must me made payable to “Raritan Area Chamber of Commerce, Inc.”   
Thank you for your cooperation.

NAME OF BUSINESS_________________________________________________________________

NAME & TITLE OF
 OWNER/REPRESENTATIVE___________________________________________________________

MAILING ADDRESS__________________________________________________________________

PHONE_______________________    FAX_____________________    E-MAIL___________________

Please check one: (   )Retail   (  )Business   (  )Professional    (  )Industry

Please check all that apply:

?	I expect to attend meetings of the Chamber
?	I would be interested in serving on a committee
?	I would be interested in volunteering time and/or providing donations for events
?	I would be interested in putting on a program for the Chamber
?	Please remove my business from the mailing list.  I do not wish to receive mailings.

Comments:  Programs you would like to see and/or experience you have that would 
be valuable to the organization

_______________________________________________________________________________

                         YEARLY DUES SCHEDULE    (based on the number of employees) 
                                                     From July 2007 to June 2008
____	I would like to be a member.  I have enclosed a check in the amount noted below.

               Number of Employees                 Dues Fee        Circle amount               
                   1-10                             $  75                                         	  
                   11-25                              100                                           	
                   26-50                              125                                          	     
                   51 to 100                          150                                          	        
                   Over 100                           175                              		      

DIRECTORY
Regardless of whether you will be a member of the RACC, one of our goals is to 
provide prospective shoppers and residents with a directory of all businesses in Raritan.  
PLEASE PRINT CLEARLY OR TYPE so that your business may be included in the directory. 
 Thank you for your cooperation.

Business Name___________________________________________________________________________

Street Address__________________________________________________________________________

Telephone Number______________________________

Business Type (for proper category______________________________________________________

Signature_______________________________________________   Date_________________________ 

Print Name______________________________________________________________________________