BEN Registration/Wait List

Registration/wait list for BEN Program. Semesters begin in January & July

Fields marked with an * are required.

Chamber Membership *

Please confirm that your business currently a member of the North Texas LGBT Chamber of Commerce in good standing?

BEN Group Preference *

In which BEN Group would you like to be placed?

Business Category (include specialization if applicable) *

What is your business category? Please enter one category only.

Business Name *

First Name *

Last Name *

Email *

Mobile Phone *

Comments (optional)