Member

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category: *

Business Keywords (enter a space between words): *

Comments / Questions:

How did you learn about the Lewisville-Clemmons Chamber?:

Chamber benefits you are seeking:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Sponsor Member: $550.00
Corporate Member: $300.00
Member: $175.00
Non-profit Member: $100.00

Additional Fees:

Application Fee : $25.00
Application Fee

Additional Opportunities:

We will contact you with additional information.

Monthly Meeting Prepaid Lunch Fee : $110.00
Prepay for the year for your monthly meeting lunch fee (optional) Enhanced Listing on Website : $75.00
Automatically rotate to the TOP of the listings in your business category (optional) Additional Category in Website Directory : $10.00
Add your business to an additional category on our website (optional)

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address