Member

By submitting this application, I confirm that I understand that my membership fee is to be paid in full at the time that I join the Chamber, and that it is non-refundable. The Henry County Chamber of Commerce has my permission to send emails and other electronic forms of communication to me. My annual renewal will be automatic unless I notify the Chamber 60 days prior to my anniversary of joining.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website: *

Email: *

Directory Category:

Employees: *

Full-time Part-time

Comments / Questions:

Minority-Owned Business:

Veteran-Owned Business:

Woman-Owned Business:

LGBTQ+ Owned Business:

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: *

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Social Networking:

LinkedIn Facebook Twitter

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Print Application

Member Application

Mailing Address

Address