Language
English (US)
Spanish (Latin America)
Cen-Tex Hispanic Chamber of Commerce Membership Form
Contact Information
Primary Contact Full Name
*
First Name
Last Name
Primary Contact Email
*
example@example.com
Primary Contact Phone Number
Please enter a valid phone number.
Secondary Contact Full Name (Optional)
First Name
Last Name
Secondary Contact Email
example@example.com
Secondary Contact Phone Number
Please enter a valid phone number.
Membership Options
Membership Level
Corporate Business (251+Employees)- $1,000
Major Business (25-250 Employees)- $400
Small Business (3-24 Employees)- $200
Micro-Business (1-2 Employees)- $150
Non-Profit- $125
Individual Supporter- $50
Student- $50
Senior- $50
Employer/Affiliation
*
Business/Organization Information
Name of Business/Organization
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Website
Instagram
Facebook
LinkedIn
Business Category
*
Short description of your business/organization
*
Do you have any promotional items that you want to include in our New Member Welcome Package? If yes, we will be contacting you to identify a pick-up date.
*
Yes
No
Not Yet
Additional Information & Payment
How did you hear about us? (If referred by someone, please share by who)
*
Reason(s) for joining
*
Are you interested in a ribbon cutting? If yes, we will follow up with you to select a date.
*
Yes
No
Are you interested in coming on Noticias (a Waco Cable Channel News production filmed at City Hall) for a 13 minute interview to showcase your business/organization?
*
Yes, in English
Yes, in Spanish
Not at the moment
Payment
If you would like to be invoiced, please email Dytrun@wacohispanicchamber.com. If payment now please make sure to click the pay with credit card below the credit card logos.
Pay online via our website below. Click the button that says "Pay with Credit Card" to complete your payment.
Submit
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