INVESTOR PAYMENT FORM

 
If you know your investment amount, you may use this secure online form below to submit your payment.

To determine the amount due, you may view the investment levels based on full-time employees and company type on the BRAC Investment Schedule. You may contact Gabrielle Roussel at gabrielle@brac.org or 225.381.7164 if you have any questions at any time.
   
Company Information (to be displayed online)
Company Name *
Physical Address *
City *
State *
Zip *
Company Telephone *
Billing Contact
First Name
Last Name
Street
City
State
Zip
Telephone
Email
Mailing Address (if different)
Street
City
State
Zip
Website
Twitter Handle
Primary Directory Category *
Brief description of business for free listing on the Baton Rouge Area Chamber website (35 words or less) *

This will be used on the BRAC website.

Primary Contact Person
First Name *
Last Name *
Title
Telephone *
Email *
Please provide contact information for employees to be added to our email lists. All employees have access to BRAC events, communications, etc.
Additional Information
Committee Interests:
BRAC Representative Who Assisted You
Membership Investment

Click here to view investor levels and pricing.

Industry: *
Number of Full Time Employees: *  
Number of Rooms:  
Number of Professionals  
Millions in Annual Deposits:  
Thousands in Net Annual Revenues:  
FuturePAC gives businesses a voice on political issues and candidates that impact the economic landscape of the Capital Region.
Total ($)

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
tempValueForDropDown1
Number of Seats (Restaurants):  
Number of Part Time Employees: *  
$ 
$ 
$ 
Additional Directory Categories
  • Primary Directory listing is complimentary
  • Up to two additional Directory listings are complimentary
  • After two, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories**
*
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Credit Card Information
Credit Card Type *
Credit Card Number * 
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Investments in the Baton Rouge Area Chamber are not tax deductible as a charitable contribution, but a portion is deductible as a business expense. Since BRAC engages in lobbying, under federal law 12 percent of annual investments are non-deductible and 88 percent are deductible.

Please click submit only once

PLEASE SELECT AN INDUSTRY TYPE BEFORE SUBMITTING