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Member Application
Business Information
Company Name:
*
Leave Blank:
Phone:
*
Website:
Email:
*
Directory Category:
--- Select Primary Category ---
Accountants
Advertising/Promotions
Agriculture
Antiques/Estate Sales/Consignments
Apartments
Architectural Design & Building
Art Galleries
Arts & Crafts
Assisted Living
Attorneys
Audio-Visual Productions
Automotive
Banks
Banks & Credit Unions
Beauty Salons/Spas
Books & Stationery
Childcare
Childrens Clothing/Toys
Chiropractors
Churches
Cleaning Services
Clothing/Shoes
Community Organizations
Computer Service/Sales
Construction Management
Consultants
Contractors
Counseling
Country Clubs
Credit Unions
Dance
Drug & Variety Stores
Dry Cleaners
Education
Elected Officials
Entertainment
Event Planning
Facility Services
Financial & Investment Services
Financial Consulting
Fishing
Fitness
Florists
Food & Beverage/Catering
Forestry
Funeral & Cremation Services
Gifts & Specialty Items
Government
Graphic Design
Grocery Stores
Hardware
Holistic Health
Home Furnishings
Hospitals & Clinics
Hotels/Motels
Human Resource Services
Insurance
Interior Design
Investments
Jewelry
Landscaping
Legal Services
Libraries
Liquor Store
Mail Services/Shipping
Manufacturing & Production
Marine Charters, Sales & Service
Marketing
Massage Therapy
Medical Supply
Medical, Dental & Nursing Care
Mortgage Banking
Moving & Storage
Nonprofits
Office Furniture & Supplies
Office Services
Optical Services
Personal Services
Pets
Pharmaceuticals & Medical Equipment
Photographers/Photo Finishing/Framing
Press/Publications/Radio
Printing & Typesetting Services
Property Leasing & Management
Public Relations
Real Estate Services
Resorts
Restaurants
Restaurants & Specialty Dining
Security Services
Shopping Centers
Signs & Banners
Sporting Goods
Tax Preparation
Taxi
Telecommunications
Title Services
Travel
Utilities
Veterinarians
Wholesale
Employees:
*
Full-time
Part-time
Comments / Questions:
Physical Address
Line 1:
*
Line 2:
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
Mailing Address
Same as physical address
Line 1:
Line 2:
City:
State:
Postal Code:
Country:
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
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:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
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:
*
--- Select Country ---
Canada
United States
Membership Options
Membership Package:
*
Silver Membership Dues (Annual)
:
$300.00
- Full 12-month membership -Member website listing by alpha and category in the LCCC Business Directory on www.lakecountychamber.com with link to your website, business description, logo, photo and video slideshow ($150 value) - New member spotlight on LCCC social media sites ($100 value) - Free job postings, member discounts and news releases on LCCC website - Member pricing for all LCCC networking, Multi-Chamber and Signature Events - Free Listing in annual LCCC Community Guide with reduced Advertising opportunities ($100 value) - Promotional opportunities on LCCC website and social media sites - Member participation in the Hispanic Chamber of Lake County - Discounted membership with participating local chambers - Opportunity to participate on LCCC Committees and Board - Ribbon Cutting/Grand Opening Support including email blast
Non-Profit Membership Dues (Annual)
:
$150.00
Includes all the benefits of a Silver Membership. To qualify for this special membership rate, please provide the Chamber a copy of your IRS determination letter.
Gold Membership Dues (Annual)
:
$600.00
Includes all the benefits of a Silver Membership PLUS: •One (1) free monthly Certification for Documents of Origin ($50 value) and a 20% discount on additional Certificates of Origin. - Free Listing of up to two (2) Locations/Branches in LCCC Community Guide ($200 value) - One (1) free pass to Networking After Hours event - One (1) free email blast ($100 value)
Platinum Membership Dues (Annual)
:
$1,200.00
Includes all the benefits of a Silver Membership PLUS: - Free Listing of up to three (3) Locations/Branches in the Community Guide ($300 value) - Recognition at all LCCC networking, Multi-Chamber and Signature Events ($500 value) - One (1) Signature Event Sponsorship of your Choice ($1,000 value): - Forecast Lake County - Annual Awards Business Dinner - Hispanic Chamber Gala - Legislative Breakfast - Two (2) free email blasts ($200 value)
Payment Option:
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