Member - Bellville Chamber of Commerce, TX

Member Application

We would love to have you as part of our organization.
Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words): *

Comments / Questions:

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 Twitter Instagram Pinterest

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Instagram Pinterest

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:

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook Twitter Instagram Pinterest

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Business Membership: $175.00
1-5 Employees Business Membership : $250.00
6-20 Employees Business Membership: $350.00
21-50 Employees Business Membership: $400.00
51-100 Employees Business Membership: $700.00
101-300 Employees Business Membership: $950.00
301+ Employees Retirees: $100.00
Individual not affiliated with a business: $125.00
Non-Profit Organizations: $100.00
Business Membership Discount:
$75 Discount for Members with 2nd Business

Additional Opportunities:

We will contact you with additional information.

Major Investors : $1,500.00
President's Club $1,500 + Basic Membership Dues Sponsorship - Platinum : $750.00
Platinum Sponsorship $750 + Basic Membership Dues Sponsorship - Gold : $500.00
Gold Sponsorship $500 + Basic Membership Dues Sponsorship - Silver : $300.00
Silver Sponsorship $300 + Basic Membership Dues

Payment Option:

Bill me Charge my credit or debit card

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