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Please attach a business card.

BUSINESS INFORMATION

Business Name: _________________________________________________________________ Physical Address: ________________________________ City: _______________ Zip:_________ Mailing Address: _________________________________ City: _______________ Zip:_________ (If different from street address)

Billing Address: __________________________________ City: _______________ Zip:_________ (If different from street address)

Email: ______________________________________________ Phone: ____________________ Website: ____________________________________________ Fax: ______________________ Business Category: _______________________ Additional Listing(s): __________________________ (Additional fees may be assessed depending on your membership level) ____________________________________________________________

My business is:

(Please circle any that apply)

Minority-owned

Woman-owned

Under new ownership

Number of Employees: __________ Years in Business: __________

REPRESENTATIVE CONTACT INFORMATION

Primary Contact: Mr. Ms. Mrs. Dr. ___________________________________________________ Title: ____________________________________ Email: _______________________________ Phone: ___________________________________ Fax: ________________________________ Billing Contact: Mr. Ms. Mrs. Dr. ___________________________________________________ Title: ____________________________________ Email: _______________________________ Phone: ___________________________________ Fax: ________________________________ Additional Representatives: Name: ____________________________________ Email: ______________________________ Name: ____________________________________ Email: _______________________________

PAYMENT OPTIONS

If paying by credit card, I authorize the Chamber to automatically debit my card on my annual anniversary date. I understand that I can discontinue this at any time. Please call the Chamber office to pay by credit card over the phone. If paying with a check, please include your check number on this application.

Membership Level: _______________ Amount: $__________ Circle One: Cash

Credit Card

Check# ______

Signature: _____________________________________ Date: _____________________


WE HEAR YOU... WELCOME TO THE CUSTOMIZED COMMUNICATION CAMPAIGN Email is the preferred method of communication for most of our members so we send e-blasts to deliver updates on Chamber news, events, volunteer opportunities and more. We understand that our members get lots of emails every day and we only want to send messages that you want to read. Please help us customize our communication by sharing what types of messages you are interested in receiving. You can circle examples below and return this page with your application, or talk it over with Chamber staff to develop a custom communication plan that works best for your business. Weekly Update & Monthly E-Calendar Delivered to all Chamber members Continued Education Opportunities Leadership Lake Houston, Chamber 101, Chamber Seminar Series Networking Opportunities New Member Welcome Reception, Business After Hours Annual Events Lake Houston 10k/5k, Chamber Gala, Business Expo, Chamber Golf Classic, Tasting The Town Government Advocacy and Political Action Public Policy Forums, Elected Officials Reception, Legislative Trip to DC Publicity and Advertising Opportunities Community Guide and Directory, web advertising BizCom Meetings Astascocita, Humble, Kingwood & Summer Creek Monthly Luncheons Awards Luncheon, Economic Outlook, Peace Officer and Firefighter of the Year, Teachers of the Year, Salute to Healthcare Volunteer Opportunities

Member-Sponsored News Receive news, advertisements, coupons, deals and announcements from your fellow Chamber members Opt in to receive Member-Sponsored News Chamber news via text message Opt in to recieve texts from the Chamber Chamber news from social media Twitter Facebook LinkedIn Other: ___________ I prefer traditional printed mail I do not want to receive Chamber news Note, if opt out, you will not get e-communications from the Chamber. Notes and Comments: __________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

110 West Main Street Humble, Texas 77338 P: 281-466-2128 F: 281-446-7483 www.lakehouston.org


LHAChamber Membership Application