Welcome and thank you for your interest in the Lafayayette Chamber. The Lafayette Chamber is an organization dedicated to providing our members with the resources to successfully compete in today’s marketplace.

Member Application:

* Company Name:

* Phone:

Website:

* Email:

* Business Description (200 char max)

* Physical Address:

* City/State/Zip:

Country:

Mailing Address:

Same as physical address

City/State/Zip:

Country:

* Business Category:

Employees:

Full-time: Part-time:

Comments/Questions:

Primary Contact Information:

* Name (First / Last):

/

* Phone:

Fax:

* Email:

Contact Preference:

Email Phone

Social Networking:

LinkedIn:

Facebook:

Address:

Same as Company Address

City/State/Zip:

Country:

Membership Package:

	0-2 Employees: $225.00
	3-5 Employees: $240.00
	6-10 Employees: $260.00
	11-20 Employees: $290.00
	21-30 Employees: $330.00
	31-40 Employees: $380.00
	41-50 Employees: $440.00
	51-75 Employees: $510.00
	76-100 Employees: $560.00
	Over 100: Call for quote
	Individual: $110.00 Refers to non-business owner or retired person
	Associate: $110.00 Associate member is employed or associated with a company who has a full membership in the Chamber. Example: Real Estate Agent whose broker company is a member.
	Non-Profit/Religious/Fraternal Service Clubs: $130.00
	Banks/Savings & Loans/Credit Unions: Call for quote
	Second Membership: A Second Membership of same business owner is 1/2 the price of full membership. Call for quote.

Payment Option:

Charge my credit card

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