Member - Los Angeles Gay & Lesbian Chamber of Commerce, CA

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category:

Business Keywords (enter a space between words):

LGBT Business Enterprise-LGBTBE:

Disabled Veteran Business Enterprise-DVBE:

Woman Business Enterprise-WBE:

Minority Business Enterprise-MBE:

Small Business Enterprise-SBE:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Bronze - Individual/Sole Proprietor: $195.00
Silver - Company/LGBT Business Enterprise: $295.00
Silver - Non Profit : $250.00
Gold - Corporate / Hospitality : $500.00
Reciprocal LGBT Chamber Membership: $97.50
Discounted rate for members of another LGBT Chamber of Commerce Corporate Membership: $1,500.00

Payment Option:

Charge my credit or debit card

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