Membership Application

'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 *
Zip *
Phone *
Fax
Website
Email *
Main Contact
First Name *
Last Name *
Address 1 *
Address 2
City *
State *
Zip *
Title
Phone *
Email *
Additional Staff Positions Included in this Membership
Billing Address (if different)
Street
City
State
Zip
Mailing Address (if different)
Street
City
State
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)
Primary Directory Category *
Number of Chamber Members:  
Chamber Budget:  
   
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**
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):
$ 
$ 
$ 
*
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 *
Credit Card Number * 
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Please click submit only one time.  The transaction may take several seconds.