MEMBERSHIP APPLICATION ___________________________ New Member _____________________________ Renewal date _____________________________ Name _____________________________ Business Name _____________________________ Address _____________________________ City, State, Zip _____________________________ Telephone _____________________________ Fax _____________________________ E-mail Member Type
Annual Fee Donor
$100 Business
$75 Non-profit Organization
$20 Individual
$10 Suggestions for topics to be covered at future meetings: ___________________________________ ___________________________________ ___________________________________ ___________________________________ Please print and
mail with fee to: Economic Development Commission of Greater Logan Square 3014 N. Kimball Ave. Chicago, IL 60618
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