801.280-0595 ** fax 801.316-6706 ** email susan@swvchamber.org ** www.swvchamber.org

PO Box 330, 4168 West 12600 South (inside First Utah Bank) Riverton, UT84065

New Member Application

NAME:______________________________________________________________________________________

BUSINESS NAME:____________________________________________________________________________

ADDRESS:__________________________________________________________________________________

CITY:_______________________________________________________________________________________

TELEPHONE:____________________________                        FAX:____________________________________

EMAIL:______________________________________________________________________________________

Areas of Greatest Interest to Me

____   Knight of Heroes evening where we honor civic and business heroes

____   Golf Tournament (fundraiser for scholarship program)

____   Education help with Teacher Appreciation and presentation of scholarship

____   Government Affairs Committee attends Western Growth Coalition, Legislative Roundup and Meets with

           Legislature during session.      .

____   Miniature Golf Tournament is the fundraiser for the Teacher Appreciation program

____   Membershiphelps with networking lunches and member-to-member discount program

____   Ambassador welcomes new businesses andattends ribbon cuttings

____   Community participates with Town Days and helps with What’s Up in Riverton