IVCC Membership Form
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Note: Do not type in information beyond the boundaries of the fields.  
Unless all the information appears on the screen, it will not be printed out nor sent to IVCC correctly. 

Do you wish to contribute to the Scholarship Fund?    If so, amount: $

Check one:  Renewal               New Member

Check one:  Business ($40)               Organization ($40)              Individual ($25)
 
Additional web page ad (one-time donation of 25$)

Business/Organization/Individual name:

Mailing address:

Physical address:

Contact person: 

Business Phone:  Home Phone: FAX: 

Email: 

Your existing web site URL: 

Descriptive Information to be included on the IVCC web site:

Category (please state the category under which you would like your business to be listed):

Total remitted: $

To print this form, click here:

Mail the completed form, along with the remittance, to the address shown below.  Make Checks payable to the Indian Valley Chamber of Commerce.

Indian Valley Chamber of Commerce
P.O. Box 516
Greenville, CA 95947