Membership Application

Please fill out the application below and click Submit. This application will be mailed to the Louisville Chamber of Commerce and you will be contacted within the next few days. If you would like to print this application and send it with your dues directly to the Chamber, please follow the PRINT FORM link to do so. Thank you for your time and we look forward to having you as a part of our Chamber Family!

General Information
Firm:  

Name:  

Street Address:  

City:         Zip:  

---

Mailing Address:  

City:         Zip:  

Phone Number:  

Fax:  

Email:  

Web Address:  

---

Business Classification (As shown in Yellow Pages and in the Chamber Directory):


Description of goods and/or service (10 to 15 words):


Chief Executive Officers:(Local)
Name:  
Title:  

Name:  
Title:  

Contact Person:  

Referred By:  

Amount of Annual Investment (per guideline):   $

Payable:  (Please select one of the following)
Annually                  Semi-Annually                  Quarterly

This investment is payable with application and is continuous unless cancelled in advance of the due date. Investments are deductible from Federal and State Income Tax Returns as a business expense.