Louisiana Small Business Association
Join LSBA/Renew Your Membership

LSBA Membership Application

Use this form to provide payment for your LSBA membership dues.

If you are renewing, please use the renewal form.

Business Name:
Doing Business As:
Mailing Address
Address:
City:
State:
Zip:
Parish:
Street Address
Address:
City:
State:
Zip:
Parish:
Other Information
Contact Name:
Contact Title:
Phone:
Fax:
E-Mail:
# of Employees:
 
Credit Card Information
Your credit card information will be transmitted to LSBA via a secure internet connection.
Billing First Name:
Billing Last Name:
Billing Address 1:
Billing Address 2:
Billing City:
Billing State:
Billing Zip Code:
Billing Day Phone:
Credit Card Type:
Credit Card Number:
Credit Card Expiration:
Credit Card Security Code:
 
Membership Dues $100.00 Annually
Dues to LSBA are not deductible as charitable contributions for federal income tax purposes. Dues may be deductible as an ordinary business expense.
 
©2019 LSBA P.O. Box 44367, Baton Rouge, LA 70804-4367 • Phone: (844) 242-LSBA (5722) • info@LouisianaSBA.org