Membership - Join the Bossier Chamber

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Please fill out our On-line Application form. When you are finished, click the "Submit Application" button located at the bottom of the page. We will process your completed application regarding your membership. * = Required Field

Bossier Chamber Membership Application
* Firm Name:
* Representative:
* Physical Address:
* City:
* State:
* Zip Code:
* Mailing Address:
* City:
* State:
* Zip Code:
* Telephone No. (000-000-000):
* Fax No. (000-000-000):
* Email Address:
Internet Address:
* Number of full-time employees in the Bossier/Shreveport area:

Business Classification: (Choose the appropriate classification and provide additional information if requested):
Financial Institution	$ in assets
Hotel/Motel	No. of rooms
Apartment	No. of units
HomeBased
Individual
Other (please describe)

* Category
Sponsored by: (volunteer or staff)
* Name of person requesting membership:
* Contact Number: (000-000-000)

Additional Reps:
First Addtional Rep
Name:
Contact No. (000-000-000):
Email Address:
Second Addtional Rep
Name:
Contact No. (000-000-000):
Email Address:
Third Addtional Rep
Name:
Contact No. (000-000-000):
Email Address: