La Quinta Chamber of Commerce 760-564-3199

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La Quinta Chamber of Commerce Application for Membership

Please provide the information requested below. This information will appear online in the membership database and in our Membership Directory. This form is secure & encrypted for your credit card transactions.

CONTACT & BUSINESS INFORMATION
Required field are in bold

Application Type:

RENEWAL NEW ($35 setup fee applies)

Main Contact:

Company Name:

Address:

City:

State:

Zip:  

Phone:

  Fax:  

Sponsor:

(Referred by)

Business Type:

Email Address::

Website:

Describe your business in one sentence or give your tag line:

 

MEMBERSHIP DUES SCHEDULE (Annual Dues)

Business/Professionals
2nd Business/Same Owner 50% Off 1st year - Contact us for details

 

$189.00 (1 - 5 employees)

 

$268.00 (6 - 19 employees)

 

$320.00 (20 - 49 employees)

 

$399.00 (50 - 149 employees)

 

$478.00 (150+ employees)

Clubs/Organizations

 

$137.00

Associate/Resident or Retired

 

$105.00

Permission to Email or Fax

 

Yes, Email     Yes, Fax      No, Email         No, Fax

 

Birthday (Month/Day)  

Diamond Sponsorships are available. Call us at 760-564-3199 for details.

Payment Information

Type of Card:  

Visa Mastercard

Name on Card: 

Card Number:

  Exp. Date: (mm/yy)

I agree to pay the dues I selected above. Please charge my credit card above.