Latin American Chamber of Commerce
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Annual Membership Renewal
Business Name:
LACC Member ID Number:
First Name:
Last Name:
Title:
Address:
City:
State:
Zip Code:
Phone:
Mobile Number:
Fax:
Email:
Website:
Legal Structure:
Corporation
Partnership
Sole Proprietorship
Year Established:
Number of Employees:
Type of Business:
Service
Retail
Wholesale
Manufacturing
Construction
Products or Services:
NAICS CODE(s):
Annual Sales:
M/W/D/VBE or SBA 8(a) Certified?
MBE Certified
WBE Certified
DBE Certified
VBE Certified
SBA 8(a) Certified
Not Certified
Sponsored By:
Please identify your company’s important accomplishments during the past fiscal year.
Annual Membership Investment
Business with Annual Revenues:
Up to $5,000,000
$275
$5,000,001 to $20,000,000
$450
$20,000,001 to $50,000,000
$600
Corporate Members Annual Revenues:
Greater than $50,000,000
$1,500
Bank Members:
Community Banks
$750
Regional Banks
$2,000
Sponsors:
Corporate Donors:
$3,000
Corporate Patrons:
$5,000
