This information will be used on the website listing and member directory. Please complete and return with payment.
New Member _____
Renewal _____
2015 Member Application/Renewal Form
Business NameContact Name / Title
Port Townsend Business Lic# (if in city limits) / State UBI#
Business Address / Mailing
City / State / Zip Code
Phone / Toll Free
Email Address / Website
Other emails to add to e-newsletter list
Check here if you want your email address to remain private
Check here if you prefer to receive communication from the Chamber electronically
Additional Business or Location listing ($75 each):
Tell Us About You!
When is the anniversary of your business?
Who or what motivated you to join or renew with the Chamber?
Please indicate your reasons for joining the Chamber (select all that apply):
Networking / Want to be involved in policy decisions / Leadership Opportunities
Business Exposure / Want to learn business skills / Other
Type of Business – This will help us categorize you in our directory (select all that apply):
Accommodations / Government / Retail & Shopping
Arts, Entertainment & Culture / Health, Wellness & Beauty / Services
Building & Construction / Individuals / Technology & Manufacturing
Business & Professional Services / Marine Trades / Tourism & Adventure
Education / Non-Profits / Transportation
Emergency Services / Real Estate / Other:
Food & Farm / Restaurants, Food & Beverage
Your customers are (select all that apply):
Locals / Tourists / People Looking to Move Here
Professionals / Non-Local / Other
2015 MEMBERSHIP PACKAGES
¨ $1,395 Business Investor ($348.75 Quarterly)
· Logo and company name featured on Chamber website with web link, monthly print newsletter, weekly e-newsletter
· 1 front page ad in the Chamber monthly newsletter and on Chamber website
· Expanded Internet Listing on Chamber website & PTguide.com ($120 value)
· Brochure/Rackcard ($50 value)
· Business listing in print version of Member Directory
· 2 Monday Lunch Meeting sponsorships ($100 value)
· Sponsorship at annual Business Leader, YPN, Citizen of the Year Event ($100 value)
· 10 E-newsletter inserts ($200 value)
· 3 inserts in Chamber print newsletter ($180 value)
· Access to Chamber healthcare benefits
¨ $995 Business Builder ($248.75 Quarterly)
· Company name featured on the Chamber website with web link, monthly printed newsletter, weekly e-newsletter
· Expanded Internet Listing on Chamber website & PTguide.com ($120 value)
· Brochure/Rackcard ($50 value)
· Business listing in print version of Member Directory
· 2 Monday Lunch Meeting sponsorships ($100 value)
· Sponsorship at annual Business Leader, YPN, Citizen of the Year Event ($100 Value)
· 8 E-newsletter inserts ($160 value)
· 2 inserts in Chamber print newsletter ($120 value)
· Access to Chamber healthcare benefits
¨ $395 Business Connector (For those committed to expanding their business)
· 1 Monday Lunch Meeting sponsorship ($50 value)
· Expanded Internet Listing on Chamber website & PTguide.com ($120 value)
· Brochure/Rackcard or 1 printed newsletter insert ($50 value)
· Business listing in print version of Member Directory
· 6 E-newsletter inserts ($120 value)
· Access to Chamber healthcare benefits
¨ $295 Business Promoter (For those ready to benefit from greater visibility)
· Expanded Internet Listing on Chamber website & PTguide.com (includes logo & business description) ($120 value)
· Brochure/Rackcard service at Visitor’s Information Center or 1 printed newsletter insert ($50 value)
· Business listing in print version of Member Directory
· Access to Chamber health care benefits
· 50% off one Chamber newsletter insert ($30 value)
¨ $195 Business Contributor (Ideal for new & beginning business owners)
· Basic listing on Chamber website ( Does not include a web link & photo/logo)
· Basic listing on PTguide.com
· Business listing in print version of Member Directory
· Access to Chamber health care benefits
· 50% off one Chamber newsletter insert ($30 value)
¨ $125 - Special Categories
· Non-profit & Governments
¨ $99
· Individual Supporter & Elected Officials
o Basic Listing on www.jeffcountychamber.org and www.ptguide.com
o Listing in membership directory
Customize Your Membership:
¨ $75 Additional Business Listing
¨ $75 Additional Location (each)
¨ $50 Brochure/Rackcards at VIC
¨ $120 Expanded Internet Listing (web link, logo, detailed business description on Chamber & PTguide websites)
¨ $50 Meeting Sponsorships (see sponsorship form for details)
¨ $60 Newsletter Insert (8 ½ x 11 flyer inserted in printed newsletter distributed to 425 members)
¨ $20 E-newsletter Insert (distribution to over 1000 email addresses)
¨ $30 Job Opportunity Posting on Website
¨ $100 Electronic Membership List (address only)
¨ $80 Member mailing list printed labels
Rental Options
Community Reader Board varies
Projector/tent/stage rentals varies
Payment Method
Total Membership Investment for 2015 ______
¨ Check enclosed for total amount due ¨ Bill me quarterly ($7 service fee applies)*
¨ To pay by credit card – please call our office at 360-385-7869 ¨ Bill me semi-annually ($7 service fee applies)
*Automatic Authorization required on credit card payment s for quarterly & semi-annual billing.
Jefferson County Chamber of Commerce • 440 12th Street • Port Townsend, WA 98368 • 360-385-7869