Lexington Area Chamber of Commerce

Membership Application

Business Name:

Mailing Address:

City: State: Zip:

Physical Address:

City: State: Zip:

Billing Address:

City: State: Zip:

Business Phone:

Business Fax:

Website Address:

E-mail Address:

Main Contact:

Title:

Main Contact's Email:

Membership Investment: $

Number of Employees/Partners:

Signature: Title:

(Signature required on file to complete application process)

Date:

Payment:

Check (Please mail or bring to Chamber office)
Cash (Please do not mail; bring to Chamber office)
Credit Card (Please complete below or visit the Chamber office. Thank you)

Credit Card Type:

Visa
MasterCard
Discover

Credit Card Number: Exp. Date:

Join The Chamber