Membership Application

Welcome! With members like you, we are able to provide a sustainable business community in Leander; and foster growth and positive change. Through your support can we continue to fund important community initiatives and lead the way for business.

Please fill out the membership application completely. If there is anything you do not want published, indicate it on the form.

For information about Chamber membership levels and the benefits included in each level, visit the Member Benefits page.

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

Enter Below

Physical Address

Business Categories

Category 1

Primary Representative

Name
Title
Email
Use Member Phone	Rep Ph.
Mailing Address
	,


Physical Address
	,

Billing Representative

Primary Rep is Billing Rep
Uncheck if your organization has different primary and billing reps

Membership Dues
Select Membership Level

Please note: If you are a small business or nonprofit organization, you are eligible for a reduced fee of $175 per year if you elect automatic recurring payments. Please call us to confirm the setup of your account after you complete your application. The $25 will be refunded to you after the setup is complete.