Member

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Directory Category: *

Employees: *

Full-time Part-time

Comments / Questions:

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Social Networking:

LinkedIn Facebook

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone: *

Fax:

Email: *

Contact Preference:

Email Phone

Login: *

Password: *

Social Networking:

LinkedIn Facebook

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

Login:

Password:

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1:

Line 2

City:

State:

Postal Code:

Country:

Membership Options

Membership Package: *

Professional Membership: Leadership St. Bernard Class 12: $0.00
A Professional Membership is defined as an individual person joining the St. Bernard Chamber as an individual. This membership level is for Leadership St. Bernard Class 12 members! Annual Membership: Non-Profit: $150.00
Join now and don't pay again until January 2026! Annual Membership: 1-2 Employees: $175.00
Join now and don't pay again until January 2026! Annual Membership: 3-5 Employees: $225.00
Join now and don't pay again until January 2026! Annual Membership: 6-10 Employees: $275.00
Join now and don't pay again until January 2026! Annual Membership: 11-25 Employees: $450.00
Join now and don't pay again until January 2026! Annual Membership: 26-50 Employees: $750.00
Join now and don't pay again until January 2026! Annual Membership: More than 50 Employees: $1,250.00
Join now and don't pay again until January 2026! Annual Membership: Professional Membership: $100.00
Join now and don't pay again until January 2026! (A Professional Membership is defined as an individual person joining the St. Bernard Chamber. The individual will be listed by name and not by company.)

Payment Option:

Bill me Charge my credit or debit card

Member Application

Mailing Address

Address

Address