Membership Application

Please fill in the application form below and submit. We will send an invoice for your membership dues.


company name

contact person

contact email
() -
phone number
() -
fax number

email for publication

additional emails to receive correspondence

company website
Mailing Address:

street address

city
state
zip
Shipping Address: same as mailing

street address

city
state
zip
Billing Address: same as mailing same as shipping

billing contact

billing address

city
state
zip
Business Type (select one) / Annual Membership Dues:
Individual, civic or non-profit / $35
Small Business (owner/operator – no other employees) / $50
Under 20 employees / $125
20 or more employees / $200
Please send an invoice for the following donation (select all that apply):
Community Service:
Scholarship $
Christmas Lights $
Owen County Community Organization Active in Disasters $

Economic Development / HomeTown Competitiveness
Leadership Academy $
Youth Engagement $
Small Business Development $
Economic Development $

I am not interested in donating at this time, but please send me additional information regarding .


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