Member - Halifax County Chamber of Commerce, VA

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

Postal Code *

Please add your Postal Code.

Social Network Addresses

Facebook

MySpace

Twitter

Instagram

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Phone *

Please add your phone number.

Email *

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Phone *

Please add your phone number.

Email *

Please add a valid email.

Contact Preference

Phone

Address

Address line 1

Address line 2

Country

City

State

Postal Code

Create Account

Password *

Please add your login password.

Step 5:

Membership Package

Please select a Membership Package

Schedule A: Business and Industry

Dues based on the number of full-time employees. See fee schedule and enter fee here:

Please enter your fee.

Schedule B: Professional

Physicians, Insurance Agents, Real Estate Agents, Dentists, etc. See fee schedule and enter fee here:

Please enter your fee.

Schedule C: Accommodations

See fee schedule and enter fee here:

Please enter your fee.

Schedule D: Non-Business

Retired persons See fee schedule and enter fee here:

Please enter your fee.

Schedule E: Banks and Credit Unions

Dues based on core deposits. See fee schedule and enter fee here:

Please enter your fee.

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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Title

Title

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Create Account

Step 5:

Membership Package

Payment Option