Member Application Business Information Company Name: * Leave Blank: Phone: * Website: Email: * Physical Address Line 1: * Line 2: City: * State: * Postal Code: * Country: * --- Select Country --- Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa South Sudan Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Turkey Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World Yemen Primary Contact Information First Name: * Last Name: * Phone: Email: Contact Preference: Email Phone Login: * Password: * Billing Contact Information Same as Primary Contact First Name: * Last Name: * Phone: Email: Contact Preference: Email Phone Login: * Password: * Membership Options Membership Package: * PLATINUM INVESTOR: $10,000.00 GOLD INVESTOR: $6,000.00 SILVER INVESTOR: $3,200.00 BUSINESS DEVELOPER - 2 YEAR: $2,000.00 BUSINESS DEVELOPER: $1,200.00 BUSINESS DEVELOPER - MONTHLY: $120.00 BUSINESS BUILDER - 2 YEAR: $1,350.00 BUSINESS BUILDER: $800.00 BUSINESS BUILDER - MONTHLY: $80.00 ENGAGE - 2 YEAR : $700.00 ENGAGE: $400.00 ENGAGE - MONTHLY: $40.00 Payment Option: Bill me Charge my credit or debit card Please scroll down to view the entire policy and then click Accept. Decline I have read and accept the privacy policy of Houston Northwest Chamber of Commerce. I grant Houston Northwest Chamber of Commerce permission to contact me regarding my account, news, updates, and offers. Please read and accept the privacy policy before continuing. Print Application
