Member

Thank you for your interest in joining the Houston West Chamber! Please review membership levels by clicking the "Membership Benefits" button above.

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (500 char max):

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Referred by:

Did a member of our staff assist you with your Chamber membership?: *

If so, Please indicate which member of our staff assisted you: *

How did you hear about the chamber?: *

Please select your top reason for joining: *

I give permission for the HWCOC to email/fax/mail info to my business: *

I give permission to list my business on online directory:

Physical Address

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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 You Tube Yelp Instagram

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

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:

Fax:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Basic Membership (Yearly): $400.00
Business Builder: $755.00
Ribbon Cutting and Certificate of Origin Chairman's Circle (1-Yr): $1,995.00
Platinum Partner (1-Yr): $3,995.00

Payment Option:

Bill me Charge my credit or debit card

Print Application

Member Application

Mailing Address

Address

Address