Membership Application Click here to download our membership application as a PDF. Chamber Membership Application THE ONLY ADDRESS THAT WILL BE PUBLISHED IS THE LOCAL STREET ADDRESS. WE DO NOT PUBLISH P.O. BOXES. Type of Membership * Required New Membership Renewal of Existing Membership Business InformationName of Business * Required Name of Business * Required Local Contact Person * Required Salutation Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Mailing Address * Required Mailing Address Line 1 Mailing Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Are the mailing address and BILLING address the same? Yes, copy the mailing address to the billing address Billing Address * RequiredIf you will be paying for your membership by credit/debit card, please make sure that this billing address is the same one used for your card. Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Are the mailing address and the STREET address the same? Yes, copy the mailing address to the street address Local Street Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone 1 * RequiredPhone 2FaxWebsite - enter a valid website URL for example https://www.google.com Email * Required ClassificationsChoose classifications to make it easy for visitors to find your business via our member directory. Please select one top-level classification and up to three additional sub-classifications.Choose a top-level classification * Required Advertising & Media Agriculture, Fishing, and Wildlife Arts, Culture, and Entertainment Automotive, Aviation, and Marine Business & Professional Services Communications Computers, IT, and Technology Construction Education Employment & Staffing Family, Community, and Non-Profit Finance & Insurance Government & Municipal Healthcare Home & Garden Industrial, Manufacturing, and Petrochemical Lodging, Travel, and Tourism Other Personal Services & Care Pets & Veterinary Public Utilities & Environment Real Estate Religious Organizations Restaurants, Food, and Beverages Shopping & Specialty Retail Sports & Recreation Sub-classifications Choose up to three additional classifications for your business.Classification 1-- select a Classification --Active Shooter/Critical Incident PreparationAdvertising & MediaAgricultural RetailAir Conditioning/HeatingAir Medical ProgramApartment ComplexesApparel & AccessoriesAppliances/Sales/ServiceArchitecture FirmArts, Culture and EntertainmentAttorneysAuto Sales & ServiceAuto Service & RepairsAuto/TireAviationBakeryBanksBarBeach House RentalsBeauty CollegeBeauty SalonBeverages/DistributorsBingo HallBoutiqueBuilding SupplyBusiness & Professional ServicesCabin & Home RentalCarpet CleaningCateringCertified Equipment Operators & RiggersCertified Public AccountantsChemical CompanyChild Care/Learning CentersChildren’s PlayChildrens PlayChiropracticChurchesCitiesCivil ConstructionCoffee HouseCollegesCommercial LandlordsComposite Dunnange/MattingComputers, IT, TechnologyConstructionConstruction Aggregates SupplierConsulting-Human ResourcesContractorsConvenience StoresCounselingCredit UnionsCustom RibbonDental PracticeDentistDepartment StoresDermatology-MedicalDiesel Engine Sales & ServicesDirect Mail/MarketingEducationElderly CaregiversElectric WholesalersElectrical ContractorsElectrical Testing & MaintenanceEmbroideryEmergency Medical ServicesEmergency RestorationEmployment ServicesEngineeringEngineering ConsultantEngineering/ Materials TestingEntertainmentEnvironmental and Construction Materials TestingEnvironmental CoatingsEquipment Sales, Rentals, Parts & ServiceEvent Services/ FacilitiesFabricationsFamily, Community & Non-ProfitFarmers MarketFasteners/IndustrialFence CompanyFinance & InsuranceFinancialFinancial/Investment ServicesFire & Safety EquipmentFish Hatchery & Education CenterFishing CharterFlooring Sales & InstallationFood PantryFoundation RepairFuneral HomesFurniture StoresGas Liquification and Export TerminalGeneral ContractorsGeneral MechanicalGift ShopsGolf CourseGovernmentGraphics & PrintingGrocery StoresGymnasticsHardwareHealth Care ServicesHearing Aid Sales & ServiceHome & GardenHome Builder/Residential/CommercialHome Health Care/In Home CareHomes/Assisted LivingHomes/NursingHospitalsHotels/ MotelsHVAC Equipment & SystemsIndividualsIndustrial & Oilfield--Offshore SupplyIndustrial Coating, Scaffolding & InsulationIndustrial ContractorsIndustrial FiltrationIndustrial GasesIndustrial gasketIndustrial LaundryIndustrial Manufacturing and PetrochemicalIndustrial RecyclersIndustrial SuppliesInspectionsInsuranceInvestmentsLand Surveying & MappingLocksmith/SecurityMachine ShopManufacturersMarine/IndustrialMaterial Handlers/HaulersMeat MarketMortgageMuseumsNail SalonsNewspapersNon-Profit OrganizationOffice Machine Sales & ServiceOffice Supplies/Equipment Sales & ServiceOil & GasOphthalmologistsOptometristsOrganizationsPawn ShopPediatric DentistPet GroomingPharmaceutical CDMOPharmaciesPhysical Therapy/RehabilitationPhysician Family PracticePhysician - OtolaryngologyPhysician – Family PracticePhysician/NeurologyPhysicians OtorhinolaryngologyPhysicians - AllergyPhysicians – OtorhinolaryngologyPhysicians/ OrthopedicPhysicians/CardiplogyPhysicians/GastroenterologyPhysicians/Internal Medicine & Primary CarePhysicians/PediatriciansPhysicians/Plastic SurgeryPipeline/Crude Oil TerminalPlanners, Engineers & Construction Mngt.Plumbing ContractorsPort AuthoritiesPort-a-can Rental & Septic ServicePreservation - Corrosion ControlPublic LibraryPublicationsPurified Water & Ice SalesRadio StationsReal Estate/Commercial/ResidentialReal Estate/Personal Property Tax ConsultationReal Estate/Property ManagementRemodeling/RepairResidential AppraisalRestaurants, Food, and BeveragesRetailRetirement Community - Independent LivingRoofing ContractorsRubber LiningRV ParksRV Sales & ServiceSafety Equipment & ServicesSelf StorageShipping & PackingShoe StoreShopping & Specialty RetailShopping Centers/MallsSpa Health WellnessSports & RecreationSubstance Abuse Treatment FacilitySurveyingTattoo & Piercing StudioTax ConsultingTax ServicesTelecommunications CompanyTelephone SystemsTire DealerTitle CompaniesTowing & Recovery ServicesTransportationUpholsteryUtilitiesValve & Instrument Sales & ServiceVending MachinesVeterinary HospitalsWaste DisposalWater & Wastewater OperationWater Purification & Treatment Service/SystemsWeb Development/Web HostingWelding SuppliesWindstorm InspectionsClassification 2-- select a Classification --Active Shooter/Critical Incident PreparationAdvertising & MediaAgricultural RetailAir Conditioning/HeatingAir Medical ProgramApartment ComplexesApparel & AccessoriesAppliances/Sales/ServiceArchitecture FirmArts, Culture and EntertainmentAttorneysAuto Sales & ServiceAuto Service & RepairsAuto/TireAviationBakeryBanksBarBeach House RentalsBeauty CollegeBeauty SalonBeverages/DistributorsBingo HallBoutiqueBuilding SupplyBusiness & Professional ServicesCabin & Home RentalCarpet CleaningCateringCertified Equipment Operators & RiggersCertified Public AccountantsChemical CompanyChild Care/Learning CentersChildren’s PlayChildrens PlayChiropracticChurchesCitiesCivil ConstructionCoffee HouseCollegesCommercial LandlordsComposite Dunnange/MattingComputers, IT, TechnologyConstructionConstruction Aggregates SupplierConsulting-Human ResourcesContractorsConvenience StoresCounselingCredit UnionsCustom RibbonDental PracticeDentistDepartment StoresDermatology-MedicalDiesel Engine Sales & ServicesDirect Mail/MarketingEducationElderly CaregiversElectric WholesalersElectrical ContractorsElectrical Testing & MaintenanceEmbroideryEmergency Medical ServicesEmergency RestorationEmployment ServicesEngineeringEngineering ConsultantEngineering/ Materials TestingEntertainmentEnvironmental and Construction Materials TestingEnvironmental CoatingsEquipment Sales, Rentals, Parts & ServiceEvent Services/ FacilitiesFabricationsFamily, Community & Non-ProfitFarmers MarketFasteners/IndustrialFence CompanyFinance & InsuranceFinancialFinancial/Investment ServicesFire & Safety EquipmentFish Hatchery & Education CenterFishing CharterFlooring Sales & InstallationFood PantryFoundation RepairFuneral HomesFurniture StoresGas Liquification and Export TerminalGeneral ContractorsGeneral MechanicalGift ShopsGolf CourseGovernmentGraphics & PrintingGrocery StoresGymnasticsHardwareHealth Care ServicesHearing Aid Sales & ServiceHome & GardenHome Builder/Residential/CommercialHome Health Care/In Home CareHomes/Assisted LivingHomes/NursingHospitalsHotels/ MotelsHVAC Equipment & SystemsIndividualsIndustrial & Oilfield--Offshore SupplyIndustrial Coating, Scaffolding & InsulationIndustrial ContractorsIndustrial FiltrationIndustrial GasesIndustrial gasketIndustrial LaundryIndustrial Manufacturing and PetrochemicalIndustrial RecyclersIndustrial SuppliesInspectionsInsuranceInvestmentsLand Surveying & MappingLocksmith/SecurityMachine ShopManufacturersMarine/IndustrialMaterial Handlers/HaulersMeat MarketMortgageMuseumsNail SalonsNewspapersNon-Profit OrganizationOffice Machine Sales & ServiceOffice Supplies/Equipment Sales & ServiceOil & GasOphthalmologistsOptometristsOrganizationsPawn ShopPediatric DentistPet GroomingPharmaceutical CDMOPharmaciesPhysical Therapy/RehabilitationPhysician Family PracticePhysician - OtolaryngologyPhysician – Family PracticePhysician/NeurologyPhysicians OtorhinolaryngologyPhysicians - AllergyPhysicians – OtorhinolaryngologyPhysicians/ OrthopedicPhysicians/CardiplogyPhysicians/GastroenterologyPhysicians/Internal Medicine & Primary CarePhysicians/PediatriciansPhysicians/Plastic SurgeryPipeline/Crude Oil TerminalPlanners, Engineers & Construction Mngt.Plumbing ContractorsPort AuthoritiesPort-a-can Rental & Septic ServicePreservation - Corrosion ControlPublic LibraryPublicationsPurified Water & Ice SalesRadio StationsReal Estate/Commercial/ResidentialReal Estate/Personal Property Tax ConsultationReal Estate/Property ManagementRemodeling/RepairResidential AppraisalRestaurants, Food, and BeveragesRetailRetirement Community - Independent LivingRoofing ContractorsRubber LiningRV ParksRV Sales & ServiceSafety Equipment & ServicesSelf StorageShipping & PackingShoe StoreShopping & Specialty RetailShopping Centers/MallsSpa Health WellnessSports & RecreationSubstance Abuse Treatment FacilitySurveyingTattoo & Piercing StudioTax ConsultingTax ServicesTelecommunications CompanyTelephone SystemsTire DealerTitle CompaniesTowing & Recovery ServicesTransportationUpholsteryUtilitiesValve & Instrument Sales & ServiceVending MachinesVeterinary HospitalsWaste DisposalWater & Wastewater OperationWater Purification & Treatment Service/SystemsWeb Development/Web HostingWelding SuppliesWindstorm InspectionsClassification 3-- select a Classification --Active Shooter/Critical Incident PreparationAdvertising & MediaAgricultural RetailAir Conditioning/HeatingAir Medical ProgramApartment ComplexesApparel & AccessoriesAppliances/Sales/ServiceArchitecture FirmArts, Culture and EntertainmentAttorneysAuto Sales & ServiceAuto Service & RepairsAuto/TireAviationBakeryBanksBarBeach House RentalsBeauty CollegeBeauty SalonBeverages/DistributorsBingo HallBoutiqueBuilding SupplyBusiness & Professional ServicesCabin & Home RentalCarpet CleaningCateringCertified Equipment Operators & RiggersCertified Public AccountantsChemical CompanyChild Care/Learning CentersChildren’s PlayChildrens PlayChiropracticChurchesCitiesCivil ConstructionCoffee HouseCollegesCommercial LandlordsComposite Dunnange/MattingComputers, IT, TechnologyConstructionConstruction Aggregates SupplierConsulting-Human ResourcesContractorsConvenience StoresCounselingCredit UnionsCustom RibbonDental PracticeDentistDepartment StoresDermatology-MedicalDiesel Engine Sales & ServicesDirect Mail/MarketingEducationElderly CaregiversElectric WholesalersElectrical ContractorsElectrical Testing & MaintenanceEmbroideryEmergency Medical ServicesEmergency RestorationEmployment ServicesEngineeringEngineering ConsultantEngineering/ Materials TestingEntertainmentEnvironmental and Construction Materials TestingEnvironmental CoatingsEquipment Sales, Rentals, Parts & ServiceEvent Services/ FacilitiesFabricationsFamily, Community & Non-ProfitFarmers MarketFasteners/IndustrialFence CompanyFinance & InsuranceFinancialFinancial/Investment ServicesFire & Safety EquipmentFish Hatchery & Education CenterFishing CharterFlooring Sales & InstallationFood PantryFoundation RepairFuneral HomesFurniture StoresGas Liquification and Export TerminalGeneral ContractorsGeneral MechanicalGift ShopsGolf CourseGovernmentGraphics & PrintingGrocery StoresGymnasticsHardwareHealth Care ServicesHearing Aid Sales & ServiceHome & GardenHome Builder/Residential/CommercialHome Health Care/In Home CareHomes/Assisted LivingHomes/NursingHospitalsHotels/ MotelsHVAC Equipment & SystemsIndividualsIndustrial & Oilfield--Offshore SupplyIndustrial Coating, Scaffolding & InsulationIndustrial ContractorsIndustrial FiltrationIndustrial GasesIndustrial gasketIndustrial LaundryIndustrial Manufacturing and PetrochemicalIndustrial RecyclersIndustrial SuppliesInspectionsInsuranceInvestmentsLand Surveying & MappingLocksmith/SecurityMachine ShopManufacturersMarine/IndustrialMaterial Handlers/HaulersMeat MarketMortgageMuseumsNail SalonsNewspapersNon-Profit OrganizationOffice Machine Sales & ServiceOffice Supplies/Equipment Sales & ServiceOil & GasOphthalmologistsOptometristsOrganizationsPawn ShopPediatric DentistPet GroomingPharmaceutical CDMOPharmaciesPhysical Therapy/RehabilitationPhysician Family PracticePhysician - OtolaryngologyPhysician – Family PracticePhysician/NeurologyPhysicians OtorhinolaryngologyPhysicians - AllergyPhysicians – OtorhinolaryngologyPhysicians/ OrthopedicPhysicians/CardiplogyPhysicians/GastroenterologyPhysicians/Internal Medicine & Primary CarePhysicians/PediatriciansPhysicians/Plastic SurgeryPipeline/Crude Oil TerminalPlanners, Engineers & Construction Mngt.Plumbing ContractorsPort AuthoritiesPort-a-can Rental & Septic ServicePreservation - Corrosion ControlPublic LibraryPublicationsPurified Water & Ice SalesRadio StationsReal Estate/Commercial/ResidentialReal Estate/Personal Property Tax ConsultationReal Estate/Property ManagementRemodeling/RepairResidential AppraisalRestaurants, Food, and BeveragesRetailRetirement Community - Independent LivingRoofing ContractorsRubber LiningRV ParksRV Sales & ServiceSafety Equipment & ServicesSelf StorageShipping & PackingShoe StoreShopping & Specialty RetailShopping Centers/MallsSpa Health WellnessSports & RecreationSubstance Abuse Treatment FacilitySurveyingTattoo & Piercing StudioTax ConsultingTax ServicesTelecommunications CompanyTelephone SystemsTire DealerTitle CompaniesTowing & Recovery ServicesTransportationUpholsteryUtilitiesValve & Instrument Sales & ServiceVending MachinesVeterinary HospitalsWaste DisposalWater & Wastewater OperationWater Purification & Treatment Service/SystemsWeb Development/Web HostingWelding SuppliesWindstorm InspectionsInvestment ScheduleEmployees * RequiredEnter the approximate number of local full-time employeesGeneral CategoryChoose the appropriate investment level based on the number of full-time employees at your business.Choose a level1-10 ($250)11-15 ($275)16-20 ($300)21-25 ($350)26-30 ($380)31-35 ($405)36-50 ($450)51-75 ($505)76-100 ($550)101-125 ($600)126-150 ($650)151-175 ($700)176-200 ($750)200+ (You will be contacted by a Chamber Representative)Special CategoriesChoose a special membership category Apartment Complexes ($1.00 per unit, minimum of $250) Hotels/Motels ($2.00 per Unit, Minimum of $250) Financial Institutions ($15.00 per Million, Minimum of $250) Individuals ($75 per Person) Non-Profit Organizations ($195 Annually) None Additional Units * RequiredEnter the number of additional units (above 250). The rate for hotels/motels is $1.00 per unit. Price: $1.00 Quantity: Additional Units * RequiredEnter the number of additional units (above 125). The rate for hotels/motels is $2.00 per unit. Price: $2.00 Quantity: Additional Assets * RequiredEnter the number of additional assets (above $17 Million). The rate for financial institutions is $15.00 per Million. For example, a financial institution with $20 Million in assets should enter "3"," as the first 17 Million are included in the base rate of $250. Price: $15.00 Quantity: Services InformationChoose additional services A Web Link from our website to yours (call for pricing) Mailing labels for only $75 Membership disk for only $75 A flyer attachment or advertisement in our newsletter with over 700 copies distributed per issue for only $100 Mailing Labels (hidden field - do not delete) * Required Price: Membership Disk (hidden field - do not delete) * Required Price: Flyer attachment (hidden field - do not delete) * Required Price: Payment terms * RequiredWould you prefer to pay annually or semi-annually? Annually Semi-Annually Payment form * RequiredHow would you prefer to make your payment? Check mailed to the Brazosport Chamber Online via credit/debit card 50% Discount for semi-annual membership (Hidden - do not delete) * Required Price: $0.00 Subtotal (hidden - do not delete)Total $0.00 Credit Card DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Expiration Date Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Notes/Special InformationInclude any notes for our Chamber staff regarding this membership.NameThis field is for validation purposes and should be left unchanged. Δ