Longlac Chamber of Commerce
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Join the Longlac Chamber of Commerce
Download our
membership form
to fill in and mail.
LCC Membership Form
*
Indicates required field
Contact Person
*
First
Last
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Contact's Email
*
Contact's Cell / Phone (please include)
*
Please include if you have one.
Business Name or Name to appear online
*
Business Phone Number to appear online
*
Your Website or Facebook Page (if applicable)
*
Please include if you have one.
Email to appear online (if desired)
*
Business or Person's Address - (please include Box # if available)
*
Line 1
Line 2
City
State
Zip Code
Country
Membership Type
*
Business $75
Personal $50
Payment Method
*
etransfer
Cheque
Credit Card
Cash
If you wish to pay via etransfer please send your payment to
info@longlacchamber.com
and use the password
chamber
for the transfer.
Comment
*
Once you submit the form you will be directed to a page where payment can be made.
Want a Receipt
*
Yes
No
I agree to receiving marketing and promotional materials
Submit
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