Membership Application

Annual Membership Investment Schedule
Most Recent Annual Sales Volume	Membership Investment Amount
$500,000 to $1,000,000*	$150.00
$300,000 to $500,000	$100.00
up to $300,000	$75.00
* Each addtional $1,000,000 in Volume is $80.00

IRMA Events

Chicago Retail Merchants Association

Energy Program

Your name:
Your e-mail:
Membership Investment Amount:	$
Store Name:
Store Address:
City:
State:
Zip:
Phone:
Fax:
E-mail:
Dues Billing Contact:
Parent Company:
Total Number of Stores:
Number of Illinois Stores:
Store Locations:
Type of Merchandise:
Annual Sales Volume:
Average Ticket Size:
Store Hours:
Number of Employees:
Are You Unionized?	Yes No
Date Business Started:
Store Type:	Independent Chain Corporate
Other Organizations:
Would you be interested in joining an IRMA committee?:	Yes No
Major area of concern in your Business:

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