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    Member Application                                                                                                                                                 
                                                       The Constitutional Chamber of Commerce
                                           (Promoting the Patriotic Businesses & Workers of the United States of America)
                                                                          Membership Application
Membership Earmarks:  25% Referral Payment (Residual for Renewals)
                                            25% Lobbying for American Businesses (Not Deductible as Contribution)
                                            25% Overseas Marketing for American Businesses
                                            25% Administration Fees for Chamber Expenses
If you have any questions or comments about our membership, send them to us. We would love to know your opinion.
Specify # - 1-25 Employees ($40/yr):
Specify # - 26 or more Employees ($80/yr):
Business or Company Name:
Business or Company Contact (name/(ac)/phone#):
Home Office Location (address, suite/unit#):
City:
State:
Zip Code:
Email:
Website:
Industry/Product(s)/Service(s):
Person Referring You to Us (name/(ac)/phone #):
The following data is for Chamber use and ratings:
# of Locations in the U.S.:
# of Locations outside the U.S.:
# of American-citizen employees in U.S.:
# of American-citizen employees outside U.S.:
# of Non-American employees , w/visas, in U.S.:
# of Non-American employees outside the U.S.:
% of Sales derived from the U.S.:
% of Sales derived from outside U.S.:
% of Mat'l/Services obtained from U.S. Manufacturers/Businesses:
% of Mat'ls/Services obtained from outside U.S.:
% of Advertising obtained from U.S. agencies:
% of Advertising obtained from agencies outside U.S.:
% of Officers that are American citizens:
% of Officers that are not American citizens:
% of Directors that are American citizens:
% of Directors that are not American citizens:
% of Banking/Financing done with U.S.:
% of Banking/Financing done outside U.S.:
Do you use E-Verify to confirm employees' status?
 		Yes
  No
Please mail membership fee to:  The Constitutional Chamber of Commerce
                                                        2832 Lido Boulevard
                                                        Gulf Breeze, FL.  32563
Comments:


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