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Breaux Bridge Area Chamber of Commerce
P.O. Box 88
Breaux Bridge, LA 70517
Phone (337) 332-5406
Fax (337) 332-5424
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email
www.breauxbridgelive.com website
MEMBERSHIP/DIRECTORY
INFORMATION
Date_____________________
Business Name_____________________________________________________________________
Owner(s) Name_____________________________________________________________________
Physical Address_______________________________ Mailing Address______________________
City___________________________________State______________Zip______________________
Phone_____________________Fax____________________E-mail___________________________
Total Number of Employees: Full time___________ Part time___________ National___________
Type of Business/Membership: Retail______ Service______ Manufacturer ______Contractor______
Wholesaler______ Professional______ Public Body______ Elected Official______ Hotel/Motel/Apt.______
Hospital/Nursing Home/Medical Transportation______ Financial Institution______ Utility______
Non-Profit______ Individual______ Student______
One name per membership will be added to the mailing list. Please also list any additional contacts
to be added to the e-mail list.
Primary Contact_________________________________________________Title_______________________________
Additional Contact_______________________________________________ Title_______________________________
Additional Contact________________________________________________Title______________________________
Additional Contact________________________________________________Title______________________________
Investment Schedule
# of Employees Dues
__________________________
Retail/Service Firms and Manufacturers/Contractors
Up to 5 $75.00
Examples: Retail Stores, Restaurants, Builders, Electricians, 6-15 $125.00
Lounges, Bed & Breakfasts, Auto Dealers, Plumbers, Printers 16-25 $150.00
Wholesalers 26-50 $200.00
51-100 $250.00
101-250 $325.00
251 and up $400.00
Professionals Up to 5 $125.00
6-10 $175.00
Examples: Accountants, Attorneys, Engineers, Realtors, Physicians 11-15 $250.00
16-20 $325.00
Public Bodies
Examples: City Government, Parish Government, School Board $250.00
Elected Officials $125.00
Hotels, Motels & Apartments $300.00
Hospitals, Nursing Homes & Medical Transportation $300.00
Savings & Loans, Banks $500.00
Utilities $500.00
Clubs & Organizations-Non-Profit $75.00
Non Business Individual $50.00
Students-Non voting $25.00
Fee schedule revised 10/31/08
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