PROSERPINE 
 CHAMBER of  COMMERCE.
Active in our business community
A.B.N. 31 360 538 006

P.O. Box 551,
Proserpine4800
Phone         (07) 4945 3678
Fax              (07) 4945 5980

Website   www.chamber.proserpine.com    
Email       info@chamber.proserpine.com 

MEMBERSHIP FORM

You are a valued member of our Business Community.
The Chamber of Commerce is a valuable tools for you to
use to improve your business.

Be ACTIVE in your Chamber to enable your Chamber to
be ACTIVE in promoting our town and your business.

1st July 2004 to 30th June 2005
Annual Membership $110.00 inc GST
10% discount for payments before 10/07/2004

BUSINESS NAME :  
CONTACT NAME :  
ADDRESS :  
 
 
BUSINESS PHONE :  
BUSINESS FAX :  
A/H PHONE (for Police Commercial Watch records) :  
EMAIL :  
NUMBER OF EMPLOYEES :  
 

 

Please print this form, fill out in pen, and mail together with payment to the above address.