Member fees:

• $ 45.00 for each business
• $ 35.00 for each person

*Indicates required fields

*Date:

*Last Name:

*First Name: MI:

*Social Security Number:

*Street Address:

*City:

*State: *Zip:

*Phone Number:

*Email:

Alt. Number:

Business Name:

EI Number:

Busniess Address:

City:

State: Zip:

*Type of Business:

Event Coordinator

Wedding Planner

Promoter

Other: