Port Arthur Chamber of Commerce Membership Application

Please complete the following application form.  A member of our staff will contact you after the application has been received to complete the process.

If you would prefer to fill out the application by hand, you can download the printable application.

Details
Company/Individual Name
Phone   
Ex. (888) 555-1234
Company Website
Company Email
Year Business Established
Full Time Employees

(Closest #)

Part Time Employees (Closest #)
Addresses
Mailing Address
 
Address
Box/Apt/Suite
City
State, Zip   
Physical Address
 
Business Categories
Category 1
Online Directory Settings
Display in Online Directory
(Must be approved by Chamber)
Display Name
Phone
Fax
Online Directory Listing Address
 
Business Info
Short Description for Website
Website
Website 2
Email
Facebook
Twitter
YouTube
Primary Representative
Name  
Title
Email
Username (email recommended)
Use Member Phone
Mailing Address
Physical Address
Billing Representative
Primary Rep is Billing Rep
Uncheck if your organization has different primary and billing reps

Thank you!  A member of our staff will contact you to complete the application process.