Membership Application
BUSINESS INFORMATION
Company/Organization_____________________________________________________________
Address__________________________________________________________________________
City_________________________________ State______________ Zip______________________
 I would like my address hidden in public directories.
Phone______________________________ Fax_________________________________________
Website: _________________________________________________________________________
Billing Address (if different from above) ______________________________________________
City_________________________________ State______________ Zip______________________
Phone______________________________ Fax_________________________________________
Primary Contact______________________________ (This person will be listed in print/online)
Title__________________________ E-mail_____________________________________________
 I would like my e-mail hidden in public directories.
Secondary Contact___________________________ (This person will NOT be listed in print/online)
Title__________________________ E-mail_____________________________________________
 I would like my e-mail hidden in public directories.
Number of Employees: Full-Time____ Part-Time____ Referred by_________________________
Type of Business - List the category you would like to be listed under.
___________________________________
__________________________________________
(second category is only available on the website)
• The Chamber does not give out the e-mail addresses or fax numbers of its members.
• Each organization is allowed one voting representative.
• Your membership investment may be tax-deductible as a regular business expense but not as a
charitable deduction.
By signing this document you give permission to the O’Fallon Chamber of Commerce to market your
business, receive correspondence from the Chamber of Commerce, and use any pictures of you and/
or your staff taken at Chamber events.
Signature______________________________________________________ Date:______________
Return this application with payment to: O’Fallon Chamber, 2145 Bryan Valley Commercial Dr, O’Fallon, MO 63366
Membership Application
Our Mission: The O’Fallon Chamber of Commerce & Industries is committed to promoting the economic vitality of O’Fallon and the St. Charles County Region by engaging its members in networking
and educational opportunities, while advocating for pro-business public policy.
INVESTMENT LEVELS
Business Membership:*
1-5 employees
6-10 employees
11-20 employees
21-30 employees
31-40 employees
41-50 employees
51-75 employees
76-100 employees
101-150 employees
151-200 employees
201-300 employees
301-500 employees
500+ employees
PARTNER LEVELS
$230
$260
$315
$395
$420
$450
$545
$630
$810
$850
$920
$985
$1260
Chamber Partners choose to commit to a variety
of sponsorship opportunities throughout the year
and in turn receive special recognition according
to the partner level. For more information on
becoming an O’Fallon Chamber Partner see the
Partner Opportunity Guide.
 Visionary Partner
Members choosing to invest $4,000 or greater.
 Community Partner
Members choosing to invest $3,000-$3,999.
House of Worship
$130
Service Organization
$130
Retiree$52
Second Location
$105
 Business Partner
Members choosing to invest $2,000-$2,999.
(2 part-time employees = 1 full-time)
* All memberships are subject to a one-time
administrative fee of $25.
PAYMENT
$___________ +
Annual Investment
$25.00
Administrative Fee
+ $___________
Total Investment
 Check: Payable to O’Fallon Chamber of Commerce
 Charge: ___MasterCard ___Visa ___American Express ___Discover
Acct. No_________________________________ Exp. Date_____________
Name on Card____________________________ Verification #___________
Signature______________________________________________________
For Office Use Only:

Added to Database

Received Payment

Welcome Email
:____________

Welcome Card

Received Sticker

Introduced at
Luncheon

Ribbon Cutting
Scheduled
Return this application with payment to: O’Fallon Chamber, 2145 Bryan Valley Commercial Dr, O’Fallon, MO 63366