Waynesville St. Robert Chamber of Commerce
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Business Name: ______________________________________________________________________________________________
Address: ______________________________________________________________________________________________________
______________________________________________________________________________________________________
Point of Contact: Phone Number:
______________________________________________________ (__________)________________________________________
Email: __________________________________________________________________________________________________________
Web Site: ______________________________________________________________________________________________________
Special Promotion/Discount:
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I give the Waynesville - St. Robert Chamber of Commerce permission to run my Special Promotion/Discount on the Shop local web site, . I understand that I am to honor my promotion/discount until December 31, 2015. If my Chamber membership becomes inactive, my promotion/discount will be removed.
Signature: ______________________________________________________________ Date: _______/________/_________
Return form to:
Waynesville-St. Robert Chamber of Commerce, 137 St. Robert Blvd., Ste. B. St. Robert, MO 65584
Fax: (573) 336-5472 or email: chamber@
For more information call: (573) 336-5121
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Office use:
Received: ____/_____/_____ By: _______
______ Website
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