2005-2006 Online Membership Application

Membership Dues
(2 part-time employees equals 1 full time employee)
Before we can add your business to the Chamber membership list, your membership investment must be received.

(full time equivalent)
Annual Dues
Museums/libraries/clubs $50
1-9 $150
10-20 $250
21 and over $500

I am a: Renewing Member     New Member

Business Name:

Mailing Address:
Physical Location:
Town, State, Zip Code:
1-800 number, if applicable:
Contact Person:

First Name:


Last Name:

Email address:


Number of employees:

Would you like these listed in our Area Guide? Yes No
Would you like these listed on our Website? Yes No

Kent Wiles, President | Laurie Blake, Executive Director
407 Wilton Road | Farmington, Maine 04938
Tel. (207) 778-4215 | Fax: (207) 778-2438 | Email: info@fwcoc.org