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Member Application

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Contact

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Leave Blank

Phone *

Please add your company phone number.

Website

Email

Physical Address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your MN.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Step 2:

Additional Info

Business Description (300 char max)

Business Keywords (enter a space between words)

Directory Category

Full-time Employees

Part-time Employees

Members to Members Advantage

Referred by

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Country *

Please add your country.

Social Network Addresses

LinkedIn

Facebook

Create Account

This Login is already in use

Login *

Please add your login username.

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Fax

Email

Contact Preference

Email

Phone

Address

Same as Primary Contact Address

Address line 1

Address line 2

City

State

Postal Code

Country

Social Network Addresses

LinkedIn

Facebook

Create Account

This Login is already in use

Login

Password

Step 5:

Membership Package

Please select a Membership Package

0 - 24 employees $ 160.00 $160.00

25 employees and up $ 250.00 $250.00

Churches & Non-Profit Organizations $100.00

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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About Us

The Chamber is made up of more than 300 businesses, clubs and organizations and we provide a wide range of services and events for our members and residential community.

Links

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Lowell Area Historical Museum
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