Monroe Chamber

OF COMMERCE AND INDUSTRY

Membership Investment Agreement Form

Primary Representative _____________________________

Company _____________________________

Physical Address _____________________________

Post Office Box _____________________________

City, State, Zip _____________________________

Information Will Be On File on the MCCI On-Line Database:

Phone:

Fax:

E-mail

Web Site

Year Established:

Employs:

Please update any information directly by logging on to the chamber login at www.monroechamber.org

Your user name is: ___________________and password________________

Membership Status: Active

Based on information on file, your 2009 membership investment would be

If your business employment demographics have changed,

please refer to the 2009 investment schedule.

Please consider a voluntary contribution of any amount toward

upgrading of office technology. $

TOTAL 2009 INVESTMENT $

Your Representative’s Signature:

Date:

Please return form and investment to:

Monroe Chamber of Commerce and Industry, 1505 9^th Street, Monroe, WI 53566

Checks may be made out to MCCI.

You may also phone the Chamber with your

VISA or MasterCard information. (608) 325-7648.