Member Application
Business Information
Company Name:
*
Leave Blank:
Phone:
*
Website:
Email:
*
Business Description (200 char max):
Directory Category:
*
--- Select Primary Category ---
Accounting
Agriculture, AgTech, Agro Business
Architecture Design & Consulting
Art & Music
Auto Detailing
Automotive Services
Banks
Beauty
Beverage Alcohol Suppliers
Beverage Manufacturing
Childhood Education & Care
Civic & Social Organization
Community
Construction
Consulting Firms
Contractors
Drink
Drinks
Eat
Education
Employment
Engineering & Construction
Entertainment & Culture
Financial Advisors
Fitness
Food Manufacturing
Government
Hair Salon
Health & Wellness
Hospitality & Apperal
Hospitals & Clinics
Hotels
HVAC
Installation
Insurance
Janitorial & Waste Management
Landscaping
Lawn Care
Legal Services
Manufacturing
Marketing
Marketing
Museums, Exhibits & Tours
Non-profit
Pet Services
Potential Member
Printing & Publishing Advertising
Promotional Advertising
Public Relations
Publications
Radio & Video
Real Estate
Religious Services
Resources & Aid
Restaurants
Retail
See
Shop
Small Business Resources
Software Marketing
Sports
Staffing & Recruitment
Taxes
Telecommunications
Translation & Language Service
Transportation & Freight
Travel Agency
Utilities
Employees:
*
Full-time
Part-time
Business Keywords (enter a space between words):
Comments / Questions:
Hispanic-owned Organization?:
Industry:
*
Arts/Entertainment/Sports
Automobile Services
Beauty and Wellness
Building Services
Community and Culture Services
Construction
Consulting
Education
Engineering/Architecture
Financial Services
Food Industry
Food/Beverage Distributors
Furnishings
Government and Civic Institutions
Health Services
Insurance
Landscaping
Language Services
Legal Services
Manufacturing
Marketing/PR/IT
News Media
Printing and Promotional Services
Real Estate
Retail
Staffing
Supporter
Transportation
Venues
Distribution
Business Description (200 character max):
*
Certification:
DBE | Disadvantaged Business Enterprise
MBE | Minority Business Enterprise
DMBE | Disadvantaged & Minority Business Enterprise
WBE | Women Business Enterprise
MWBE | Women & Minority Business Enterprise
DMWBE | Disadvantaged Minority Women Business Enterprise
Veteran Business Enterprise
Hubzone
8a
501c3
In Process
No
No, but interested
Year of certification:
Where are You Certified?:
Missouri
Illinois
Not certified
Reason to join:
*
Networking & referrals
Diversity recruitment
Marketing & promotion
Business Counseling
Access to new customers
Leadership & professional development
All of the above
Other reason to join:
*
Women-owned businesses?:
*
How did you hear about us?:
*
Business registration date (Startups type ''not yet''):
*
Sales/Revenue:
*
Less than $10,000
$10,001 - $50,000
$50,001 - $200,000
$200,001 - $500,000
$500,001 - $1,000,000
Greater than $1,000,000
Demographic: Race/Ethnicity (Only for individual members):
Hispanic/Latino/Latina/Latinx
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Island
Non-profit organization?:
Restaurant?:
I would like to subscribe to the HCC Bi-Weekly Newsletter.:
Physical Address
Line 1:
Line 2:
City:
State:
Postal Code:
Country:
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Mailing Address
Same as physical address
Line 1:
*
Line 2:
City:
*
State:
*
Postal Code:
*
Country:
*
--- Select Country ---
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Social Networking:
LinkedIn
Facebook
Primary Contact Information
First Name:
*
Last Name:
*
Membership Options
Membership Package:
*
Student
:
$50.00
Individual Supporter
:
$100.00
Business / Organization (0-5 Employees)
:
$200.00
Business / Organization (6-10 Employees)
:
$300.00
Business / Organization (11-20 Employees)
:
$400.00
Business / Organization (21-50 Employees)
:
$500.00
Business / Organization (51-100 Employees)
:
$700.00
Friend
:
$1,000.00
Bronze
:
$5,000.00
Silver
:
$10,000.00
Gold
:
$15,000.00
Diamond
:
$20,000.00
Platinum
:
$25,000.00
Startup business
:
$0.00
Payment Option:
Charge my credit or debit card
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