Member Application
Thank you for your interest in joining the Mid-America LGBT Chamber of Commerce! You are just minutes away from completing your application to become a member of the Chamber. Please note that all applications are subject to board approval.
Business Information
Company Name:
*
Leave Blank:
Phone:
Website:
Email:
*
Business Description (200 char max):
Directory Category:
--- Select Primary Category ---
Accommodations - Hotels & Resorts
Accounting & Bookkeeping
Acupuncturists
Addiction Recovery
Advertising Agencies & Consultants
Antiques
Apartment Homes
Appliance Repair
Architects
Art Studios & Galleries
Arts Organizations & Information
Attorneys - Bankruptcy Law
Attorneys - Business Planning
Attorneys - Criminal Defense
Attorneys - Estate Planning & Elder Law
Attorneys - Immigration Law
Attorneys - Personal Injury
Attorneys - Real Estate
Attorneys--Employment Law
Attorneys--Tax & Estate Planning
Attorneys
Audio Visuals / Production
Automotive
Automotive Sales
Background Screening
Baked Goods & Gifts
Banking Services
Bars & Nightclubs
Beverage Distributors
Bicycle Shop
Bowling
Business & Professional Associations
Business Brokers
Casinos
Caterers
Chamber of Commerce
Chapels
Chiropractors
Churches & Synagogues
Cleaning Services
Clinics
Coffee & Tea
Coffee Shops
Colleges--Art & Design
Community Centers
Construction
Consulting--Customer Relations
Consulting
Contractors - Electrical
Contractors - Painting
Contractors
Counselors - Licensed Professional Counselors
Courier Services
Credit Card Processing
Cycling Shop
Day / Medical Spa
Dentists
Design Services
Digital Strategy / Web Development
Diversity & Inclusion Training
Drug Testing
Dry Cleaning Services
Employment & Staffing
Energy
Engineering
Entertainment
Estate Sale Services
Event Planning & Production
Event Spaces
Eye Care
Film & Video Production
Financial Planning
Financial Services - Banking
Financial Services - Investments & Insurance
Financial Services - Investments
Florists
Fundraising Services
Funeral Homes
Funeral Services
Galleries
Government Offices
Graphic Design
Greeting Cards, ECards & Gifts
Greeting Cards, Gift Wrap, Home Décor and Gift Products
Gym - Physical Fitness
Hair & Skin Care
Health & Wellness
Healthcare
Healthcare IT
HIV/AIDS Service Organizations
HIV/AIDS Services
Home Builders
Home Decor & Furnishings
Home Design
Home Repair & Remodeling
Homeless Services
Hospitals
Hotels - Lodging
Human Resource Counseling/Consulting
Individual Members
Information Technology
Insurance Services
Interior Design
Investors
Jewelers
Landscape Services
Laundry Services
Law Firms
Leadership Development Training
LGBT Business Enterprise (BE) Certified
LGBT Community Centers
LGBT Legal Services
Libraries
Liquor Stores
Locksmiths
Magicians
Manufacturing
Marketing - Internet Marketing Services
Marketing--Consulting
Marketing--Digital
Marketing--Healthcare
Marketing
Massage Therapy
Media
Medical Rehabilitation
Medical Services
Merchant Credit Card Services
Mergers & Acquisitions
Mortgage Services
Movie Theaters
Municipalities
Museums & Libraries
Nail Salons
Non-Profit Organizations & Resources
Nutrition Counseling
Office Design
Office Furniture
Office Supplies
Online Training
Ophthalmologists
Other (the Chamber will contact you to discuss options)
Parking Management Services
Payroll Services
Payroll, HR & Employee Benefits
Performing Arts
Pet Services & Products
Pharmacies
Photographers
Physicians
Plumbing Services
Political
Printing Services
Professional Development Coach
Professional Education Services
Promotional Products
Public Relations
Public Utilities
Publications
Publishers
Radio Stations
Real Estate - Co-Working
Real Estate - Commercial
Real Estate - Development and Investments
Real Estate - Inspection
Real Estate - Sales
Real Estate
Remodeling/Design
Restaurant & Catering
Restoration
Retail
Roofing Companies
Salons & Spas
Security Systems & Services
Software
Sound Systems & Equipment
Speedways
Sports Teams
Swimming Pool Services
Tanning Salons
Tax Preparation
Tax Preparation, Negotiation & Representation
Telecommunications
Television
Theatres
Theatres--Cinema
Theatres--Live Performance
Therapists
Title and Escrow Services
Training, Consulting & Business Coaching
Translation Services
Transportation
Travel & Tourism
Travel Agencies
Universities
Universities
Veterinary Services
Video Production
Website Development
Wedding Apparel
Wedding Officiant/Clergy
Weddings and Events Coalition (WECo)
Weight Loss
Wigs & Extensions
Wines & Spirits
Youth Education
Employees:
Full-time
Part-time
Business Keywords (enter a space between words):
Comments / Questions:
LGBT Owned:
LGBTBE Certified:
51% or more woman owned?:
Current Woman Owned Business Enterprise (WBE) certification?:
51% or more minority owned?:
Current Minority Business Enterprise (MBE) certification?:
Current Disadvantage Business Enterprise (DBE) certification?:
Current Minority owned Business Enterprise (MBE) Certification?:
Who Were You Referred By? :
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
British Virgin Islands
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
Ghana
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
South Sudan
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
British Virgin Islands
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
Ghana
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
South Sudan
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
Social Networking:
LinkedIn
Facebook
Instagram
Twitter
YouTube
Primary Contact Information
First Name:
*
Last Name:
*
Title:
Phone:
*
Email:
*
Contact Preference:
Email
Phone
Login:
*
Password:
*
Social Networking:
LinkedIn
Facebook
Instagram
Twitter
YouTube
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
British Virgin Islands
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
Ghana
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
South Sudan
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:
*
Email:
*
Contact Preference:
Email
Phone
Login:
*
Password:
*
Social Networking:
LinkedIn
Facebook
Instagram
Twitter
YouTube
Address
Same as Member Address
Line 1:
*
Line 2
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Canada
United States
Membership Options
Membership Package:
*
Principal Underwritter
:
$10,000.00
$10,000 Annually
Chairman's Level Underwritter
:
$7,500.00
$7,500 Annually
President's Level Underwritter
:
$5,000.00
$5,000 Annually
Executive Level Underwritter
:
$2,500.00
$2500 Annually
Business Leadership Membership
:
$1,000.00
$1,000 Annually
Business Premium Membership
:
$750.00
$750 Annually
Business Plus Membership
:
$495.00
$495 Annually
Business Basic Membership
:
$295.00
$295 Annually
Wedding and Events Coalition - Rainbow Membership
:
$495.00
$495.00 Annually / Package includes a Business Basic Chamber membership in addition to your WECo Rainbow membership
Wedding and Events Coalition - Celebration Membership
:
$750.00
$750.00 Annually / Package includes a Business Basic Chamber membership in addition to your WECo Celebration membership
Wedding and Events Coalition - Salute Membership
:
$1,000.00
$1000.00 Annually / Package includes a Business Basic Chamber membership in addition to your WECO Salute membership
Wedding and Events Coaltion - Inspiration Membership
:
$1,500.00
$1500.00 Annually / Package includes a Business Basic Chamber membership in addition to your WECo Inspiration membership
Non-Profit Member--100 or more employees (501(C)3 or Gov't agencies only)
:
$495.00
$495 annually
Non-Profit Member--less than 100 employees (501(C)3 or Gov't Agencies only)
:
$295.00
$295 Annually
Individual Member - Non Business
:
$195.00
$195 Annually / This membership is built to serve the individual seeking to join the Chamber of Commerce without a business association. There will no listing included in the Business Directory
Monthly Business Basic Membership
:
$28.00
$28.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Business Plus Membership
:
$45.00
$45.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Business Premium Membership
:
$68.00
$68.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Business Leadership Membership
:
$88.00
$88.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Wedding and Events Coalition - Rainbow Membership
:
$45.00
$45.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Wedding and Events Coalition - Celebration Level
:
$68.00
$68.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Wedding and Events Coalition - Salute Package Membership
:
$88.00
$88.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Wedding and Events Coalition - Inspiration Package Membership
:
$135.00
$135.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Large Non-Profit Membership
:
$45.00
$45.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Small Non-Profit Membership
:
$28.00
$28.00 Monthly / Selection of this membership level requires the use of a credit or debit card for payment and your selection of automatic monthly payments. We can not approve monthly memberships that request the bill me option.
Monthly Individual Membership
:
$18.00
$195 Annually / This membership is built to serve the individual seeking to join the Chamber of Commerce without a business association. There will no listing included in the Business Directory This membership does not include a listing in the annual directory.
Payment Option:
Charge my credit or debit card
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