2026 Membership Application
Membership covers January 1st through December 31st of each calendar year
Business/Organization/ Individual Name
*
Please enter name(s) if applying for individual or couples membership
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
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Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Communication Preferences
Please check all that apply
How would you like us to communicate with you?
Email
Phone Call
Mail
Text*
Primary Chamber Contacts
Please list up to two people we may contact regarding Chamber communications.
Contact #1
Required field
Name
*
First Name
Last Name
Title/Role
*
E-mail
*
example@example.com
Work Number
Mobile Number
Contact #2
Optional
Name
First Name
Last Name
Title/Role
E-mail
example@example.com
Work Number
Mobile Number
Engagement Interests
Optional: Please check any areas of interest.
Additional info:
Yes, our business is interested in hosting a Chamber After Hours Event.
Our business (or I am) interested in promoting the Scholarship Program
A representative from our business is interested in serving on the board of directors.
Name:
If different from above, please provide the preferred contact for these activities.
Email:
Membership Options
Please select the appropriate category and dues
Individual -- $50
Couples -- $75
Non-Profit Organization -- $100
Business 1-5 Employees -- $100
Business 6-19 Employees -- $125
Business 20-99 Employees -- $200
Business 100-199 Employees -- $300
Business 200+ Employees -- $350
Payment Summary
Membership Dues:
*
Optional Scholarship Contribution:
Additional Donation
Total Amount:
*
Thank you for your interest in joining the Arcadia/Bienville Parish Chamber of Commerce.
Online Payment is coming soon. While our secure payment portal is being finalized, our team will be happy to assist you with submitting your membership dues and any optional contributions. Payment may be submitted by mail or arranged directly with the Chamber office. Mail payments to: P.O. Box 587 Arcadia, LA 71001
Print Form
Submit Membership
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