Choose Your Team
Event Planning
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Membership


Thank you for your application. Your membership will be active after payment is recieved
First Name:
Last Name:
Address:
City:
State: (ignore for non-US transactions)
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Credit Card Billing Address
 
 If the address where you receive the credit card bill is different than above, please enter it here.
Address:
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Zip Code:
 

What benefits are you most looking for from your membership?
Would you like someone form the Latina Chamber to contact you after submitting this payment?
Are you a renewal member?
How did you first hear of the Latina Chamber?
Wouls you like to volunteer with the Latina Chamber?
Citrine: $100.00, Blue-Topaz: $250.00, Garnet:$500.00, Pearl: $1,000.00, Emerald:$3,000.00, Ruby: $5,000.00
Charge Amount:
$50.00 Amethyst: Senior/ Student Membership
$100.00 Citrine: Individual
$250.00 Blue Topaz: Non Profit Oraganization or For-Profit Company (1-49 Employees)
$500.00 Garnet Membership: Non-Profit Organization (50 + Employees)
$500.00 Business Garnet Membership: 11-50 employees
$1,000.00 Pearl Membership: 51-99 employees
$3,000.00 Emerald Membership: 100 - 249 employees
$5,000.00 Ruby Membership: 250 - 499 employees
Make this a Recurring Transaction?  
By default your card will only be charged today, with no recurrence set up. However, you can use the fields below to specify a recurring payment on the schedule of your choosing. Change the recurrence to specify how often your transaction will be processed. Specify an end date to stop transactions after a certain point in time (if you are unsure, use the expiration of your credit card).
Recurrence:
End Date: Not required. Defaults to your card expiration month and year
Pay by Credit Card  
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
C V V Value: