Membership Form

Ready to join? Fill out your application below!

- Step 1 of 5

Please Check Your Economic Alliance Contact: *

Chad Burke
Chad Carson
Marisela Ramirez
Patti Bell
Amanda Baucum
Karen Gregory
Heather Carrico

Member Contact Information

This information is required to enter you into our database if your application is accepted.

Company:

Company Name *

Billing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Website

Billing Contact:

Name *

First

Last

Title *

Phone Number *

Email *

President/Owner:

Name *

First

Last

Title

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Mobile Number

Email *

Primary Liaison from your company to Economic Alliance

Please indicate the primary liaison for your company. This individual will be the primary point of contact for the Economic Alliance for your company's membership.

Name *

First

Last

Title *

Phone Number *

Mobile Number *

Email *

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Task Force Sign Up:

Quality of Life
Public Policy
Business Growth
Economic Development
Workforce Development
Gulf Coast Industry Forum
Women’s Leadership Luncheon

Do you have additional liasons to add? *

Liaison 2

Name

First

Last

Title

Phone Number

Mobile Number

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Task Force Sign Up:

Quality of Life
Public Policy
Business Growth
Economic Development
Workforce Development
Gulf Coast Industry Forum
Women’s Leadership Luncheon

Liaison 3

Name

First

Last

Title

Phone Number

Mobile Number

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Task Force Sign Up:

Quality of Life
Public Policy
Business Growth
Economic Development
Workforce Development
Gulf Coast Industry Forum
Women’s Leadership Luncheon

Liaison 4

Name

First

Last

Mobile Number

Mailing Address (if different from above)

Address Line 1

Address Line 2

City

State

Zip Code

Task Force Sign Up:

Quality of Life
Public Policy
Business Growth
Economic Development
Workforce Development
Gulf Coast Industry Forum
Women’s Leadership Luncheon

Annual Membership Categories and Funding Levels

Below are the annual dues for private sector members. Please select appropriate category.

Test

Test - $ 1.00

For organizations with 1000 employees or more.

Partner Level - $ 5,000.00

- Logo on website, quarterly newsletter, and annual report.
- Consideration for Executive Board and/or Board Positions
- One complimentary 1/4 advertisement in one edition of quarterly newsletter upon joining
- First right of refusal to limited seating events
- Invitations to high level stakeholder meetings/activities
- Member Social Media promoting & leveraging
- Consideration for Task Force Chairmanship
- Invite to Membership Meetings, Task Force Meetings, and Events

For organizations with 100 employees or fewer

Stakeholder Level - $ 3,000.00

- Company name on website and quarterly newsletter
- Annual Report Folder
- Consideration for Board Position
- Member Social Media promoting & leveraging
- Consideration for Task Force Chairmanship
- Invite to Membership Meetings, Task Force Meetings, and Events

For organizations with 50 employees or fewer

Corporate Level - $ 1,000.00

- Company name on website and quarterly newsletter
- Annual Report Folder
- Consideration for Task Force Chairmanship
- Invite to Membership Meetings, Task Force Meetings, and Events

For organizations with 10 employees or fewer

Proprietorship Level - $ 500.00

- Company name on website, quarterly newsletter, and Annual Report Folder
- Invite to Membership Meetings, Task Force Meetings, and Events

For chambers of commerce (chamber presidents please check the appropriate level based on your chamber's membership size)

Fewer than 500 members - $ 250.00
500-749 members - $ 500.00
750 or more members - $ 750.00

This category of membership provides a mechanism for community chambers in our region to support regional economic development activities.

For Governmental Contract Members

Contracts negotiated on annual basis (contract period 3 years minimum)

Member Business Profile

Primary Product or Service (SIC) *

North American Industry Classification System Code (NAICS Code)

Number of Employees in this Region

Home Office Location

Number of Facilities in this Region

Primary Business Location *

Baytown
Channelview
Deer Park
Galena Park
Harris County
Highlands-Lynchburg
Houston
Jacinto City
La Porte
Pasadena
Pearland
North Shore
Morgan's Point
Seabrook
Sheldon
Shoreacres
South Belt-Ellington
South Houston

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Total Annual Dues

$ 0.00

Payment Form *

Card Number

Expiration

Security Code

Pledge *

I agree to the terms below.

I pledge amount shown as annual membership support for the Economic Alliance Houston Port Region.

Digital Signature *

Please type in your full name.

Today's Date *