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Membership Application

                

Please fill in completely and we will contact 
you with your payment and membership information.

                Annual Membership Dues:

Individual or Professional.......................$  100.00
Non-Profit Organization...........................$  110.00
Proprietor & 5 Employees........................$ 160.00
Proprietor & 6-10 Employees....................$ 210.00
Proprietor & 11-20 Employees...................$ 300.00
Proprietor & 21 or more Employees..........$ 420.00
Corporate..................................................$ 525.00

Yearly Dues are payable by Cash or Check.
Make Checks payable to:

Odessa Hispanic Chamber of Commerce
700 N Grant Ste#200
Odessa, Texas 79760

Name of Owner *
E-mail Address: *
Name of Business *
Phone *
Fax
Business Address *
Business Address 2
City *
State *
Zip Code *
Name of Officers
Products and Services Offered
Number of employees
Interested in being assigned to committee *Yes
No
Is this a *
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Manny Puga
President/CEO
president@odessahcc.org
 Odessa Texas 79760
432.333.7892
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