Member Application

Congratulations on your decision to join the Laughlin Chamber of Commerce! We proudly serve the entire Colorado River Region.

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:

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

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Twitter

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:

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Annual Membership: $235.00
1-10 Employees Annual Membership: $300.00
11-50 Employees Annual Membership: $385.00
51-100 Employees Annual Membership: $540.00
101-200 Employees Annual Membership: $690.00
201-300 Employees Annual Membership:
Over 300 employees? Please call for pricing. Non-Profit: $130.00

Payment Option:

Bill me

Print Application

Printed courtesy of www.laughlinchamber.com – Contact the Laughlin Chamber of Commerce for more information.
1585 S Casino Dr, Laughlin, NV 89029 – (702) 298-2214 – info@laughlinchamber.com