Member - East Mississippi Business Development Corporation

Step 1:

Member Info

Company Name *

Please add your company name.

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

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

Address line 2

Country

City

State

Postal Code

Step 2:

Additional Info

Business Description (60 char max)

Directory Category *

Please select a directory category.

Full-time Employees

Part-time Employees

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 *

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

Facebook

Twitter

Instagram

Create Account

Password *

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Fax

Contact Preference

Phone

Address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Create Account

Password

Step 5:

Membership Package

Please select a Membership Package

Small Business Membership $300

The basic level membership, geared for small businesses with 10 or fewer employees.

Business Advocate $500

Basic level membership $500.

Leadership Circle $1,000

Leadership Level membership $1,000.

Chamber Champion $2,500

Leadership Level membership $2,500.

Community Builder $5,000

Leadership Level membership $5,000.

Titans of Industry $10,000

Leadership Level membership $10,000.

Non-Profit/Individual Membership $125

For a non-profit organization or an individual membership. * provide 501C3 documentation

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

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Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Social Network Addresses

Create Account

Step 4:

Billing Contact

Address

Social Network Addresses

Create Account

Step 5:

Membership Package

Payment Option