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Member Application

Please fill out the following to submit your application for membership in the Natchitoches Area Chamber of Commerce. See also the Ribbon Cutting/Grand Opening guidelines under "Ribbon Cuttings" to your left. Please provide a short description of your business below--this description is a selling point for your business and customers will see this information. It can be changed later. Additionally, enter up to eight keywords to help search engines find your page and products/services. You will be able to change this information later from the member portal. Thank you!

Business Information

Company Name: *

Phone: *

Website:

Email:

Business Description (200 char max): *

Business Category:

Employees: *

Full-time Part-time

Business Keywords:

Keyword 1 Keyword 2 Keyword 3 Keyword 4 Keyword 5 Keyword 6 Keyword 7 Keyword 8

Comments / Questions:

Establish: *

Physical Address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State / Province: *

ZIP / Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook Twitter Digg reddit

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

Zip / Postal Code:

Country:

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Title:

Phone:

Cell Phone:

Fax:

Email:

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook Twitter Digg reddit

Address

Same as Company Address

Line 1:

Line 2

City:

State / Province:

ZIP / Postal Code:

Country:

Membership Options

Membership Package: *

Annual Membership: See fee schedule to determine the fee and enter it below.
If using fee schedule, enter fee here:

Additional Opportunities:

We will contact you with additional information.

Upgraded Online Directory Listing
Enhanced website directory listing includes up to 20 key words to help visitors find your business, expanded business description, and embedded video and picture gallery. (Monthly fee)

Payment Option:

Bill me Charge my credit card

In the effort to fight spam, please provide the answer to the following question.

What is the sum of 6 plus 6?: *

Print Application