Port Isabel Chamber of Commerce Membership Form (Benefits)
Please fill-in your information, check the applicable options, print this form, sign it, and mail or drop it off at:
Port Isabel Chamber of Commerce • 421 Queen Isabella Blvd. • Port Isabel, TX 78578
Business Name:
 _____________________________________________________________________________
Type of Business:
 _____________________________________________________________________________
Owner/Mgr.:
 _____________________________________________________________________________
Address:
 _____________________________________________________________________________
City:
 _____________________________________________________________________________
State:
 _____________________________________________________________________________
ZIP:
 _____________________________________________________________________________
e-Mail:
 _____________________________________________________________________________
Website:
 _____________________________________________________________________________
Telephone:
 Bus.:________________________________ Fax:______________________________
Description of Business:
_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________
Ribbon Cutting Dates:
 First Choice: __________________________ Second Choice: _________________________
Membership Groups: check one.
Membership
Group 1
 1 to 5 Employees - - - $150.00
6 to 15 Employees - - - $175.00
16 to 25 Employees - - - $200.00
26 to 35 Employees - - - $225.00
35 to 50 Employees - - - $250.00
51 to 100 Employees - - - $275.00
Membership
Group 1I
 Hotels - $1.50 per room
Condos - $1.00 per unit
RV Parks - $0.50 per space
Minimum Investment - $150.00 per year
Membership
Group III
 Professionals: $150.00 plus $25.00 per additional associate.
Membership
Group IV

Check one business type
& employee number group.

 Banks
Newspapers
Radio
Television
Utilities
1 to 5 Employees - - - $150.00
6 to 15 Employees - - - $175.00
16 to 25 Employees - - - $200.00
26 to 35 Employees - - - $225.00
35 to 50 Employees - - - $250.00
51 to 100 Employees - - - $275.00
Membership
Group V
 Non-Profit Organizations - $50.00
Membership
Group VI
 Associate Member (non-voting): $35.00 (Any person not currently associated with any business)
Payment:
 Amount: ___________________________ Check #: _____________________
Credit Card #_________________________ Expiration Date: ___/___/___
Name on card:
 ___________________________________________ MC Visa Discover Amex
Signature:
 _____________________________________________________________________________
Date:________________________________________________________________________
Return Form to: Port Isabel Chamber of Commerce; 421 Queen Isabella Blvd.; Port Isabel, TX 78578.
Telephone: 1-800-527-6102 or 956-943-2262.
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