Membership Application

Step 1: Complete Membership Application

Step 2: Submit Membership Payment

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Membership Application

Membership Type

Company

Business Title

Title

Name

First

Last

Phone

Cell Phone

Fax

Company Website

Business Description

Business Type

Other Business Type

Number of Employees (Full Time)

Number of Employees (Part Time)

Number of Employees (Male)

Number of Employees (Female)

List up to 3 Employees/Staff affliated with your Company's membership (First Name, Email, Number)

Address

City

Zip Code

What assistance do you desire from the Chamber?

Other (Specify)

If you are human, leave this field blank.

Memberships

Business	Employees	Cost
General CORE Membership	1-100	$200

Student	# Students	Cost
Student	1	$25

Employers with 200+ employees are encouraged to contact the chamber via email, info@northbatonrougechamber.org, to seek sponsorship opportunities.