Membership Application

Name:
Business:
Address:
City:
State:
Phone:
Fax:
Zip:

Membership Categories

	Patron		$1000 or up
	Industry		$500
	Business/Professional
		Up to 5 Employees	$125
		6 or more Employees	$225
	Churches/Organizations/Clubs		$50
	Friends of Main Street		$25
	Students		$10

Dues renewable annually.

Make payable and return to:
Kosciusko Main Street
222 E Washington St.
Kosciusko, MS 39090
662.290.0403