Member

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:

What is your main goal with chamber membership?: *

Minority-owned:

Woman-owned:

Veteran-owned:

LGBTQ-owned:

Spanish-Speaking:

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 Instagram YouTube TikTok Pinterest Yelp Apple Podcast Vimeo

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

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:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

0-5 Full Time Employees: $400.00
6-10 Full Time Employees: $450.00
11-20 Full Time Employees: $550.00
21-50 Full Time Employees: $730.00
51-100 Full Time Employees: $945.00
100+ Full Time Employees: $1,115.00
Banks/Public Utilities: Please contact us to determine the fee.
LEAD Athens Alumni Association Dues: $50.00
*LEAD Athens Alumni Association Membership Only - Not a Chamber Business Membership

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address