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Resources
Resource Library
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Hoosier Chamber Academy
>
Hoosier Chamber Academy Class of 2020-21
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Careers
COVID-19 Resources For Chambers & Businesses
ICEA Board Resource Portal (log-in for ICEA Board)
Professional Development
Professional Consultation
Scholarships
Professional Designation
Annual Awards
>
2020 Award Finalists
2021 Award Finalists
Events & News
Calendar
Annual Conference
Hoosier Chamber Academy
Chamber Day At The Statehouse
News
Blog
About Us
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Contact
Membership Application - Indiana Chamber Executives Association
'ICEA membership proves to be the most beneficial investment that our chamber makes each year.'
That's what one chamber president had to say. Investing in ICEA membership pays off for your chamber's professional staff. Don't delay another day - complete the
membership application
and return it with payment ASAP to start tapping into the vast array of benefits offered only to ICEA members.
Organization Information (to be displayed online)
Organization Name
*
Address 1
*
Address 2
City
*
State
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
*
Phone
*
Fax
Website
Email
*
Main Contact
First Name
*
Last Name
*
Address 1
*
Address 2
City
*
State
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
*
Title
Phone
*
Email
*
Additional Staff Positions Included in this Membership
First Name
Last Name
Title
Email
Year Began Chamber Career
First Name
Last Name
Title
Email
Year Began Chamber Career
First Name
Last Name
Title
Email
Year Began Chamber Career
First Name
Last Name
Title
Email
Year Began Chamber Career
First Name
Last Name
Title
Email
Year Began Chamber Career
Billing Address (if different)
Street
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
Mailing Address (if different)
Street
City
State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Zip
Additional Information
Referring Chamber
Year You Began Paid Chamber Work
Membership Investment
Investment for ICEA Membership:
*
(Cost of membership is based upon
Chamber annual operating budget)
Select one..
Tier One - $150 (Less than $100,000 budget)
Tier Two - $225 ($100,000 – 250,000 budget)
Tier Three - $300 ($250,000 - $500,000 budget)
Tier Four - $375 ($500,000 - $1 million budget)
Tier Five - $450 ($1 million+ budget)
Primary Directory Category
*
None
Chamber of Commerce
Number of Chamber Members:
Chamber Budget:
Annual Membership Investment
Total: $
The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
tempValueForDropDown1
Additional Directory Categories
Primary Directory listing is complimentary
Up to two additional Directory listings are complimentary
After two, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories**
none
Number of Part Time Employees:
Number of Rooms (Accommodations):
Number of Seats (Restaurants):
Number of Associates (Realtors, Attorneys):
Number of Locations ($35/add. location):
Enhanced Membership ($50):
Additional Categories Cost
$
One-Time Application Fee
$
Tax
$
Payment Type
*
Credit Card
Check
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information
Credit Card Type
*
Mastercard
Visa
Discover
Amex
Credit Card Number
*
Name On Card
Security Code
Valid Through
01
02
03
04
05
06
07
08
09
10
11
12
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
Use Address Above
Credit Card Address 1
Credit Card City
Credit Card State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
AG
BN
BS
CH
CL
CM
CP
DF
DU
GR
GT
JA
MC
MR
MX
NA
OA
PU
QE
QR
SI
SL
SO
TB
TL
TM
VE
YU
ZA
Outside US
Outside Canada
Outside Mexico
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
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