Please provide the following contact information:

Items in BLUE are required, check the include box to indicate you would like a field shown on the website and listed in the printed directory. E-mail is requested to facilitate communications and meeting notifications

Fields marked by * are for the Deluxe Membership only - description is up to 255 characters long -- for longer, please send an e-mail with the full text to the webmaster.

NAME			Include
Position/Title			Include
ORGANIZATION			Included
Street Address			Include
Address (cont.)			Include
City			Include
State/Province			Include
Zip			Include
Country			Include
MAILING ADDRESS			Include
Address (cont.)			Include
City			Include
State/Province			Include
Zip Code			Include
Country			Include
PHONE			Included
Phone 2			Include
Fax			Include
E-MAIL			Include
URL*			Include
Short Description*			Include
TYPE	Art, Advertising & Design Automotive & Tires Banks Churches Clubs & Organziations Construction & Related Community Related Health & Massage Home & Garden Libraries Lodging Museums Outfitters Real Estate & Property Management Recreation Restaurants, Cafes & Bars Schools/School Districts Services Stores, Shops & Markets
	This will be used to make your listing easier to find.

Please provide the following contact information about your primary membership if you this form is for an additional business listing:

NAME
ORGANIZATION
PHONE
E-MAIL

Your membership/listing will not be official until payment is received by:

EDC
Attn. Secretary
P. O. Box 1091
Oak Creek, CO 80467