Online Membership Application

Application is hereby made for membership in the Greater Lafayette Commerce to help underwrite the business growth and civic improvements of the Greater Lafayette area. When membership investment is current, membership is continuous until written resignation is submitted.

Company Name: *

Phone Number: *

Street Address: *

City, State Zip Code: *

Reason for Joining: * select...Business InformationCommunity InvolvementCredibiltyNetworkingEventsAdvocacyWebsite ExposureEconomic Development

Business Classification: *

Please choose from our list of categories in our Membership Directory (will open in a new tab/window).

Number of Full Time Employees: *

E-Mail Address: *

Web Address: *

Home Office Location: *

Date Firm Established: *

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Date Established in Area: *

MonthJanFebMarAprMayJunJulAugSepOctNovDec

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Year180018011802180318041805180618071808180918101811181218131814181518161817181818191820182118221823182418251826182718281829183018311832183318341835183618371838183918401841184218431844184518461847184818491850185118521853185418551856185718581859186018611862186318641865186618671868186918701871187218731874187518761877187818791880188118821883188418851886188718881889189018911892189318941895189618971898189919001901190219031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015

Total Annual Dues: *

Please choose your required level of dues from our Annual Dues page (will open in new tab/window).

Contact Person: *

Title: *

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