Business Membership Application Long Lake Chamber of Commerce Business/Company Name Business Physical Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Business Phone * (###) ### #### Type of Phone (Check one) * Land Line Cell Email Address * Website Address (optional) http:// Product & Services Offered Food Gas Lodging Bart/Tavern Subject * Message * Primary Contact Name * First Name Last Name Mailing Address If different than Business Address Address 1 Address 2 City State/Province Zip/Postal Code Country Optional Phone (###) ### #### Thank you!
