ECONOMIC CLUB OF LAPEER COUNTY CORPORATE MEMBERSHIP

Corporate Membership Fee: $575 for 3 employees
$175 for each additional employee beyond 3

Company:
Office Street:
Office City:
Office State:
Office Zip:
Office Phone:
Number of Employees:
Miss	Ms.	Mrs.	Mr.
Enter primary member name:
Title:
Home Street:
Home City:
Home State:
Home Zip:
E-mail address:
Include in membership directory:	Yes	No
Home Phone:
Send Mail To:	Office	Home
Sponsor a luncheon ($500):	Yes	No
Sponsor a school to attend a luncheon ($40):	Yes	No
Miss	Ms.	Mrs.	Mr.
Enter second member name:
Title:
E-mail address:
Include in membership directory:	Yes	No
Home Street:
Home City:
Home State:
Home Zip:
Home Phone:
Send Mail To:	Office	Home
Miss	Ms.	Mrs.	Mr.
Enter third member name:
Title:
E-mail address:
Include in membership directory:	Yes	No
Home Street:
Home City:
Home State:
Home Zip:
Home Phone:
Send Mail To:	Office	Home

Please return application and check payable to Economic Club of Lapeer County.
Thank you for your support.