Membership Application

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* Firm or Individual Name

Primary Chamber Contact

* First Name:

*Last Name:

* Title

*E-mail:

Fax Number

Business Location Information

*Location Address:

* Location City

* Location State

* Zip Code:

Mailing Location Information

Mailing Address

Mailing City

Mailing State

Mailing Zip Code:

* Main Phone Number

* Employees: FT PT

Sponsor

Business Categories (1st is free, additional $50 each)

* Business Category 1

Business Category 2

Business Category 3

* Brief description of business or service:

Online Presence:

Website Address

Facebook Page Address

Twitter Address/Username

Other Representative(s):

Number of representatives is related to dues amount and are indicated on the dues schedule.

Other Representative(s) 1

Other Representative(s) 2

Other Representative(s) 3

*Please select the most important reason you are joining the Greater Las Cruces Chamber:

I hereby apply for membership in the Greater Las Cruces Chamber of Commerce. The Chamber will contact you with the full amount of your annual investment.

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