Member

To preview your annual dues, click Step 5 below.
Individuals, retired professionals, and remote workers with expressed permission from their employers who are out of the area may select the "Sole Proprietor" rate. 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!

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