Greater Silver Spring Chamber of Commerce Membership Application IMPORTANT: Please complete all information for speedy processing of your application Name of Business Representative Type of Business Number of employees (at this location) Street Address City State Zip Code Phone Fax E-Mail Web Site   Please link my site to the GSSCC Web site ($50 per year)   Please include my company logo and link my site to the GSSCC Web site ($175 per year) Brief description of business (15 words or less) Main Reason for joining the chamber: Referred to GSSCC by:   GSSCC memberships are corporate memberships, with annual dues based on the number of employees in the business. For local branches, dues are based on the number of employees at the local branch. If you are joining for multiple locations, with an organization with no paid staff, or as an individual sales representative for a company not located in Silver Spring, please call the office for details as your dues rate may vary. Membership runs for one year from the date of dues payment (see below). Each organization shall be entitled to one vote per membership. 2011-12 Dues Schedule* Number of Employees Membership Dues Sole Proprietor $275 2 - 4 employees $335 5 - 9 employees $415 10 - 15 employees $510 16 - 24 employees $615 25 - 40 employees $715 41 - 60 employees $825 61 - 75 employees $925 76 - 100 employees $1,030 101 - 350 employees $1,190 Over 350 employees $1,800 *Rates are subject to change without advance notice Membership dues may be deductible as an ordinary business expense. Please submit your application below. An invoice for first year dues will be mailed to you upon receipt. Membership will become effective upon receipt of payment and Board Approval.

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Tel: (301) 565-3777 Fax: (301) 565-3377 8601 Georgia Avenue, Suite 203, Silver Spring, MD 20910