NAME ______________________________________________
BUSINESS __________________________________________
Please check the events you will attend:
| EVENT |
DATE | # ATTENDING |
| Monthly
Luncheon Meeting |
___________ | ____________ |
| After
Hours (After Hours Mini-Expo) |
___________ | ____________ |
| Joint
Chamber Networking Event |
___________ | ____________ |
| Educational
Seminar |
___________ | ____________ |
| Other Event | ___________ | ____________ |
To pre-pay for the event/s, please complete the following:
AMOUNT: ____________
NAME ON CARD _______________________________________
ACCOUNT NUMBER ____________________________________
EXPIRATION DATE ______________
AUTHORIZATION CODE (3 digits on back) ________
CREDIT CARD MAILING ADDRESS ________________________________________________________
________________________________________________________