3540 Clemmons Road, Suite 112 Clemmons, NC 27012
336.970.5100

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Member Application

Thank you for your interest in joining the Lewisville-Clemmons Chamber of Commerce. Please fill out the member application form today and start receiving the benefits of being a Chamber member! You may contact us at the Chamber at 336.970.5100 for more information.

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Info

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

LinkedIn

Facebook

Step 2:

Additional Info

Business Description *

Please add your company description.

Business Keywords * (enter a space between words)

Please add your business keywords.

Directory Category *

Please select a directory category.

How did you learn about the Lewisville-Clemmons Chamber?

Chamber benefits you are seeking

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

LinkedIn

Facebook

Step 4:

Billing Information

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

LinkedIn

Facebook

Step 5:

Membership Package

Please select a 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 Options:

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)

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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