ALSCO

Member Application

The benefits of becoming a Chamber member are endless and are all designed to help you grow your business to success! Dues are based on number of employees (two part time employees equals one full time employee) and payment is required before your membership application can be processed. We accept Master Card, Visa or American Express online or you may pay with check or cash by mail or in person. Be sure and add your email address to your application in order to receive our weekly events newsletter!

Business Information

Company Name: *

Phone: *

Website:

Email:

Business Description (200 char max): *

Business Category:

Employees:

Full-time Part-time

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1:

Line 2:

City:

State / Province:

ZIP / Postal Code:

Country:

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

Zip / Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

ZIP / Postal Code:

Country:

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 7 plus 6?: *

Print Application

Contact Us

435-628-1658

97 E St. George Blvd,
St. George, UT 84770

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