Member Application

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Phone:

Email:

Contact Preference:

Email Phone

Password: *

Billing Contact Information

Same as Primary Contact

First Name:

Last Name:

Phone:

Email:

Contact Preference:

Email Phone

Password:

Membership Options

Membership Package: *

PLATINUM INVESTOR: $10,000.00
GOLD INVESTOR: $6,000.00
SILVER INVESTOR: $3,200.00
BUSINESS DEVELOPER: $1,200.00
BUSINESS DEVELOPER - MONTHLY: $120.00
BUSINESS BUILDER: $800.00
BUSINESS BUILDER - MONTHLY: $80.00
ENGAGE: $400.00
ENGAGE - MONTHLY: $40.00

Payment Option:

Bill me Charge my credit or debit card

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Contact

Houston Northwest Chamber of Commerce
4201 Cypress Creek Pkwy (FM 1960 W), Suite 195
Houston, TX 77068

Phone: (281) 440-4160
Email: ChamberInfo@HoustonNWChamber.org