P.O. Box 147 / 7648 Fancy Gap Highway - Fancy Gap, Virginia 24328 E-mail: info@blueridgehost.com
	Blue Ridge HOST is a public - private organization dedicated to promoting the heart of the Blue Ridge Parkway as a visitor's destination. We support the Twin Counties, Mount Airy, Carroll, Patrick, Floyd, Henry, and Bland/Wythe Chambers of Commerce and the areas they serve. We are also linked to other organizations that support the Blue Ridge Parkway, Southwest Virginia, North Western North Carolina and the surrounding area.
	To become a Blue Ridge HOST member, you should be a member of a local Chamber of Commerce Listed above in order to receive the full benefits of membership.
	Please complete the following information and mail your dues to the address listed above. Keep a copy for your records. (See below for additional information about your website listing and membership). You may upload your picture for your listing below or email it to info@blueridgehost.com. If you are paying for multiple businesses, please submit a separate form for each membership. If you have any questions concerning your dues amount, or your membership, please contact us at the above address or contact Don Foster at (276) 398-3207.

	Business Name:	(required)
	Mailing Address:	(required)
	City:	(required)
	State/Zip:	<Select A State> Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    (required)
		State if not listed above:
	County:	(required)
	Contact Person:	(required)
	Contact Title:	(required)
	Physical Address:	(required)
	Local Phone:	(required)
	Cell Phone:
	Fax Phone:
	Contact E-Mail Address:	(required)
	E-mail for Inqueries	(required)
	Website Address:
	Chamber Affiliation:	(required)

Blue Ridge HOST (www.blueridgehost.com) requests a reciprocal link from your website to ours. We will be glad to forward you our logo to use as a link from your site.

Membership Dues:

Membership - $100.00 (Within (5) miles of the Parkway)     Accommodations, retail, recreation, restaurants, real estate, etc. Supporting Membership - $100.00 (Outside (5) mile limit of parkway)     Accommodations, retail, recreation, restaurants, real estate, etc. Contributing Membership - $100.00 (Any Location)     Institutions, Media, Suppliers, and Arts and Crafters Non Profit / Churches - $0.00

		Your membership starts immediately upon acceptance into the organization. You will be billed each year thereafter; during the month of membership acceptance. All dues are subject to change based on our yearly evaluation of services offered as an organization, and the need to provide better services. Dues cannot be raised unless voted on by the board and approved by its members. Multiple memberships are 50% of original dues for each additional membership. A separate form is needed for each membership.
		Please include a (200) two hundred word description of your business for our Website. You may upload a picture to appear with your listing, but the file size may be no larger than 1 MB (1024KB). If your picture is too large to upload here or you would like to submit multiple pictures, you may email your pictures to our webmaster at info@blueridgehost.com.

	Upload Photo:
	Description:
	By submitting this form you agree to the following conditions: I understand understand that the upload of a photo or image constitutes permission to use the photo without any subject to copyright infringment. Member will indemnify and hold Blue Ridge Host harmless form any costs, expenses (including reasonable attorney's fees) or liability arising from any claim that such materials infringe the intellectual property.