Online Membership Application

Company Information

Company:

Address Line 1:

Address Line 2:

City:

State:

Zip:

Phone 1:

Phone 2:

Fax:

E-mail:

Website:

Bus. Category 1:

Established Date:

Full-time Employees:

Part-time Employees:

Business Description:

Character Limit: 0/500

Logo:

Images must be less than 1MB in file size.

Image size may not exceed 1MB.

Create Member Account Login

Your member account allows you to update your information online via a secure login.

Admin E-mail:

Password:

Verify Password:

Contacts

Primary Contact

Prefix:

First Name:

Last Name:

Suffix:

Familiar Name:

Title:

Create Login

Your member login allows you to update your information online and register for events.

Username:

Password:

Verfiy Password:

Use Company contact information

Billing Contact

Send invoices to Primary Contact

Total:

$0.00

I agree, that as a condition of membership in the Logan County Chamber of Commerce, I and my employees or representatives will conduct my business in a manner that is ethical, fair, and honest in all dealings with my customers, vendors, associates, employees, and fellow businesses both on and off the internet. I further agree to promote responsible businesses practices on the internet.

Security Code:

Please enter the security code above.