First Name
Last Name
Title
Email

First Name
Last Name
Title
Email

First Name
Last Name
Title
Email

First Name
Last Name
Title
Email

First Name
Last Name
Title
Email

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost

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Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)

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Full-Time Employee Count:	Do you have 500 or more employees? Contact the Ames Chamber membership department for a Custom Memberhip Package to best fit you and your business' needs at 515.232.2310.
Number of Part Time Employees:
Number of Rooms (Accommodations):
Number of Seats (Restaurants):
Number of Associates (Realtors, Attorneys):
Number of Locations ($35/add. location):
Millions in Assets (Financial Institutions):
Enhanced Membership ($50):
Tax	$
Payment Type *	Credit Card Check
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Would you like to become a Gold Member? *Gold dues are 10% above the normal dues amount. Gold Dues ensure that our programs and events are at little or no cost to our members. Gold dues are voluntary. All Gold Members are listed in the Ames Business Monthly annually, receive a special mention in our Annual Report and receive a special Gold Member window decal.
Yes, I would like to become a Gold Member
Primary Directory Category * None Accounting & Tax Advertising Agriculture Apartments Architects Arts Assisted Living & Nursing Homes Attorneys Audio & Sound Automotive Dealership Automotive Parts & Accessories Automotive Repairs & Service Awards Bakeries Banks Bars Beauty Book Stores Bookkeeping Breweries Bridal & Tuxedo Builders & Developers Building Materials Car Wash Caterers Cellular Child Development & Care Chiropractors Clothing Coffee & Tea Computer Products & Repairs Computer Sales & Services Construction & General Contractors Consultant Contractors Cookware Counseling Credit Unions Dentists Designers & Decorators Desserts Education Electrician Employment Agencies Energy Engineers Entertainment Environmental & Ecological Services Excavating Eye Care Fire & Water Restoration Fitness Flooring Floral & Gifts Food & Beverage Distributors Funeral & Cremation Garden Centers & Nurseries Gas Station Glass Golf Government Graphic Design Grocery & Liquor Stores Gymnastics Hearing Heating & Cooling Home Furnishings Home Health Home Improvement Hospitals Hot Tubs & Pools Hotels Housing Cooperative Human & Social Services Individual Members Industrial Insurance Investment Janitorial Services Jewelry Landscape Laundries Library Lighting Manufactured Homes Manufacturers Marketing Massage Medical Clinics Medical Research & Development Mental Health Services Metal & Wood Mortgages Moving Mower Museum Newspaper Non-profit Organizations Office Supplies Orthodontists Packaging & Shipping Painting Party Supplies Payroll Pest Control Pet Boarding Pet Services Pet Supplies Pharmacy Photographer Physical & Occupational Therapy Plumbing Pre-Employment Screening Printing Property Managers Public Relations Publishing Quilting & Sewing Radio Station Real Estate Real Estate Appraisal Reception Facilities Recreation Religious Organizations Restaurants Retirement Community Roofing Security Shoes Shopping Centers Signs Software Design / Development Spa Sporting Goods Storage Surveyors Tanning Tattoos & Piercings Telecommunications Training Transportation Trash Hauling Travel & Tourism Services Utilities Veterinarians Video Wealth Management Web Design & Development Welcome Services
Additional Directory Categories (please select up to three)
**Hold CTRL on your keyboard to select multiple categories** none
Additional Categories Cost	$