By typing your name in the signature box you agree and knowledge the following:

I agree to abide by the rules, regulations and by-laws of the Brick Township Chamber of Commerce. (We will be happy to provide a copy upon request.)

I hereby give permission to the Brick Township Chamber of Commerce to fax/email correspondence from the Chamber of Commerce to the number & address provided above. I understand that no further authorization will be requested of me and that this permission will remain in effect unless I give written notice to the contrary.

Enclosed is $ ___ as our annual investment which includes a processing fee of $49.00. I understand that the processing fee includes a Membership certificate, a complete Chamber Membership list (upon request), and all other services offered by the Chamber. This amount also includes one free directory listing. Additional listings can be purchased at $25 for each additional listing. Our annual investment is renewable automatically on our anniversary date (join month) UNLESS we present written notification to the contrary. Please enclose a check or complete the credit card payment section (after submitting your application). Payment in full must accompany application.



Membership Dues Schedule

1 -2 Employees $  328.00
3 - 8 Employees $  358.00
9 - 15 Employees $  378.00
16 - 30 Employees $  418.00
31 – 50 Employees $  558.00
51 – 100 Employees $  618.00
101 - 200 Employees $  768.00
201 - 300 Employees $  948.00
300+ Employees $1,068.00

*2 Part time employees = 1 employee. ** Please note that there is a one time $49.00 processing fee included in the dues schedule above.

Company Name :
Name of Primary Contact :
Email Address* :
Please make this email public :
*In order to protect the privacy of your information, it is our policy not to publicize your e-mail address & fax number. If you would like to have this information shared with the public, you must specifically request it.
Additional Contact :
Additional Contact Email :
Street Address :
City :
State :
Zip :
Telephone :
Fax :
Please make this fax number public :
Date Business Opened :
Join Date :
Self-Employed? :
Sponsored by :
Business Home-Based? :
Retailer? :
If your address is a residence, please indicate geographic area served, if applicable :
Website Address :
We refer our members’ businesses thousands of times each year. Tell us what you do so that we can provide you with this service :
Select the Category or Categories that best describe your business as it would be in the telephone directory. (To select more than one category from list, use Control key). :
*Please note that there is no charge for the 1st category. If you wish to have your business listed in multiple categories, it is $25/per year for each additional category.
Membership Dues Schedule - includes $49 processing fee. Note: prices include one free directory category. Additional categories are an additional $25 per year per category :
Signature box :
Date :
Please submit a check made payable to Brick Township Chamber of Commerce.