The Colquitt-Miller County Chamber of Commerce Welcome You!

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Name of Business or Individual:  

Mailing Address:

City:  

State:  

E-mail Address:  

Website Address:  

(Your membership includes a link on the Chamber's Website)

Add the above address to the Chamber's Website
Yes   No  

Number of Employees:  

Date Business Established:  

Type of Business

Type of Membership
Business   Individual   Family   Senior  

I understand that, upon acceptance, this application constitutes a continuing agreement, and that our membership in Colquitt-Miller County Chamber of Commerce will continue, with dues payable annually, until such time as this agreement is terminated by either party.

Signature (electronic - please type in all capitals)

Title:  

Colquitt-Miller County Chamber of Commerce 302 E. College Street Colquitt, GA 39837 229.758.2400 - 229.758.8140 (fax) Please remit all dues to the above.