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Hermosa Beach Chamber of Commerce


Date ____________________




Business / Company Name _______________________________________________________________

Contact / Member Name ________________________________________________________________

Mailing Address ________________________________ City __________________ Zip _____________ 

Street Address __________________________________ City __________________ Zip ____________

Phone (     ) _________________________________  Fax (     ) _________________________________

Business Classification (same heading as Yellow Pages) ________________________________________

Number of Employees: Full Time ______  Part Time ______  Business was established in (year) _______

Committee Preferences:  q Membership Services        q Fiesta de las Artes        q Business Advocacy

q Governmental Affairs        q Downtown Revitalisation




Signature _________________________________________________





Return to:	Hermosa Beach Chamber of Commerce
		1007 Hermosa Avenue
		Hermosa Beach, CA 90254