BECOME A MEMBER

All levels of membership amplify the community impact. Please identify your support level below and fill out the application form.

Select

Primary Contact Person

First Name

Last Name

Company Name

Type of Business

Brief Summary of Services Provided By Company

Name(s) of Owner(s)

First Name

Last Name

Names of Additional Representatives

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Website

http://

Phone

(###)

###

####

Once membership is approved by board of directors, membership fee checks are to be made to

Upper Lafayette Economic Development Foundation. Mail to: 1400 NW Evangeline Thruway, Lafayette, LA 70501