3921 N. Meridian St. l Suite 230 l Indianapolis, IN 46208 l (317) 924-9840 - Application Contact Us

APPLICATION
 

Clck here to download apdf of the application to mail in, or please fill the form out below.

 Membership Application Form
 Application Type
New Member       Renewal
 Basic Information
Name
Title
Company
Address
City
State
Zip
Office #
Fax
Alternate #
Email
Web Address
 Company Information
 Business Category (based on yellow page listing):
 Describe company's major business activity (up to 50 words):
 Type of Ownership:
Sole Proprietorship
C Corporation
S Corporation
Partnership
Nonprofit
Other
Date Company was Established
/
Number of Employees
SIC Code
 Do your Company Export Goods/Services Outside the US?
No       Yes
If yes, what percentage of sales is export business?   %
 Annual sales volume:
Less than $100,000
$100,000 to - 500,000
$500,000 - 1 million
$1 million to - 5 million
$5 million to - 10 million
$10 million and over
 Which of the following business certifications do you hold?
Minority Business Enterprise (MBE)
Woman Business Enterprise (WBE)
Disabled Veteran
Handicapped
Other
 Membership Dues
Small Business Owner (under 50 employees) $ 250.00
Associate/Non-Business Owner $ 100.00
Major Corporation (50+ employees) $ 1,000.00
Nonprofit Organization $150.00
Small business, major corporation and nonprofit membership categories are eligible for inclusion in membership directory and IBCC's web site hot links.

Include me on the "member hot link" page of IBCC's web site:
No       Yes
 
Thank you for your support