Member Application

Thank you for your interest in the Tangipahoa Chamber of Commerce! If you are doing business in Tangipahoa or want to do business in Tangipahoa, we invite you to be a member of the Tangipahoa Chamber. Joining online is quick and easy, but if you have any questions or need assistance, we are here to help you every step of the way. Feel free to reach us at 985-345-4457.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (45 char max):

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

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: *

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone: *

Fax:

Email: *

Contact Preference:

Email Phone

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: *

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Premier Level: $3,000.00
Corporate Level: $925.00
Full Time Employees (46 or more) Executive Level: $625.00
Full Time Employees (31-45) Business Level II: $475.00
Full Time Employees (16-30) Business Level I: $325.00
Full Time Employees (1-15) Organization: $225.00
Nonprofit 501c(3), Government Office/Agency, Churches, Schools

Payment Option:

Charge my credit or debit card

Print Application