Lincoln Chamber of Commerce
~Membership Registration Form~
COMPANY INFORMATION
Tell us about yourself:
Company/Organization Name*
Address*
City
Postal Code
Phone
Fax
Email Address
Website
Name of Business Owner(s)
Hours of Business

Number of Employees
Year Established
Outline of Business/Service
Company Representatives (refer to current Nominee Entitlement Scale on Fee Schedule)
Name
Title/Position
Name
Title/Position
Name
Title/Position
Name
Title/Position
Referred by:
Name
Title/Position

I would be interested in:
Working on a Committee
Chamber's Group Insurance Health & Life
Advertising in the Business Directory

LINCOLN CHAMBER OF COMMERCE
4800 S. Service Rd., Beamsville, ON LOR 1B1
905.563.5044 or Fax: 905.563.7098
Email: lcoc@vaxxine.com  Website: www.lincolnchamber.ca