Shreveport-Bossier Military Affairs Council P.O. Box 1661 - Shreveport, LA 71165 Office (318) 429-2418 - Fax (318) 429-2419 Date Name BUSINESS INFO:Name of Business Position Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code TelephoneMember of Chamber? Yes No PREFFERED ADDRESS FOR CORRESPONDENCE Street Address Address Line 2 City State / Province / Region ZIP / Postal Code ENDORSEMENTSMember #1 (Name) Member #2 (Name) Email Address Please State Your Interest in The Military Affairs CouncilMembership Type* Basic $300 Premium $500 Signature