Become a Member - Support Main Street Illinois

SMSIL MEMBERSHIP APPLICATION

$309.30

Annual Fee

$300 annual fee
+$9.30 online transaction fee

$206.30

Annual Fee with proof of valid membership in a partner association.

$200 annual fee
+ $6.30 online transaction fee

If paying via mail, Please fill out and submit the form below and mail your check or money order, payable to SMSIL PAC to:

Support Main Street Illinois Coalition
PO Box 167
Morris, IL 60450

DOWNLOAD FORM

Please fill out all fields below completely and accurately as this information will be used for administrative purposes and for our website member directory. If you are more comfortable mailing the form to us with your payment, please click the ‘DOWNLOAD FORMS’ button above to download and print the form.

CONTACT INFORMATION

BUSINESS INFORMATION

Name *

Business Name *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Business Phone

Email *

Website / URL

DONATE TODAY

SMSIL DONATIONS:

Donations to the Support main Street Illinois Coalition (SMSIL) play an increasingly important role in providing support to those legislators who understand and defend our industry. The time to act is NOW! Don’t sit on the sidelines. Contribute NOW to PROTECT YOUR video gaming revenues and your business.

$ Donation Amount:

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Offline Donation
PayPal

Personal Info

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Last Name

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Comment

Billing Details

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Address 2

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Donation Total: $50.00