Member

To preview your annual dues, click Step 5 below.
If your organization has more than 1000 employees, please call the Chamber at 434.295.3141 before you apply. Annual dues are nonrefundable. We look forward to connecting with you!

Please note: Your Chamber membership is activated upon full payment of dues.

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Business Description (200 char max): *

Directory Category: *

Employees: *

Full-time Part-time

Business Keywords (enter a space between words):

Comments / Questions:

Total Employees: *

Industry Sector:: *

If you selected ''Other'':

NAICS Code:

Year Founded: *

County/Locality: *

# of Rooms (Hotel/Lodgings Only):

Is your organization a Minority Business Enterprise? (at least 51% owned by one or more minority individuals): *

If your business is a Minority Business Enterprise and you are not the owner, please list the owner's name and email address.:

Is your organization certified under the Commonwealth of Virginia's Small, Women-owned, and Minority-owned Business (SWaM) program?: *

Is your organization a not-for-profit entity?: *

Is your organization veteran-owned?: *

Is your organization a Virginia Values Veterans (V3) certified organization?: *

Are you a graduate of the CIC Entrepreneur Workshop? If yes, what month & year?:

How did you hear about us?: *

Chamber staff who referred you?:

Were you referred by a current Chamber member? If yes, please list their name:

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: *

Social Networking:

LinkedIn Facebook Twitter Instagram

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Print Application

Member Application

Mailing Address

Address

Address