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
Position/Title
ORGANIZATION
Street Address
Address (cont.)
City
State/Province
Zip
Country
MAILING ADDRESS
Address (cont.)
City
State/Province
Zip Code
Country
PHONE
Phone 2
Fax
E-MAIL
URL*
Short Description*
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 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