Member Application

To preview your annual dues, click Step 5 below.
If your organization has more than 1000 employees, please call the Chamber at 434.295.3141 before you apply. Annual dues are nonrefundable.

We look forward to connecting with you!

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 *

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

Twitter

Instagram

Step 2:

Additional Info

Business Description (200 char max) *

Please add your company description.

Business Keywords (enter a space between words)

Directory Category *

Please select a directory category.

Full-time Employees *

Please add your number of full-time employees.

Part-time Employees *

Please add your number of part-time employees.

Total Employees *

Looks good!

Industry Sector: *

Looks good!

If you selected ''Other''

NAICS Code

Year Founded *

Looks good!

County/Locality *

Looks good!

# of Rooms (Hotel/Lodgings Only)

Is your organization a Minority Business Enterprise? (at least 51% owned by one or more minority individuals) *

Looks good!

If your business is a Minority Business Enterprise and you are not the owner, please list the owner's name and email address.

Is your organization certified under the Commonwealth of Virginia's Small, Women-owned, and Minority-owned Business (SWaM) program? *

Looks good!

Is your organization a not-for-profit entity? *

Looks good!

Is your organization veteran-owned? *

Looks good!

Is your organization a Virginia Values Veterans (V3) certified organization? *

Looks good!

Are you a graduate of the CIC Entrepreneur Workshop? If yes, what month & year?

How did you hear about us? *

Looks good!

Chamber staff who referred you?

Were you referred by a current Chamber member? If yes, please list their name

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 *

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.

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.

Title

Phone *

Please add your phone number.

Cell Phone

Fax

Email *

Please add a valid email.

Contact Preference

Phone

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.

Create Account

Password *

Please add your login password.

Back Next Submit Application Print Application

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

Building Business. Building Community.