Use this form to register for a Networking Event via emailing, mailing or dropping off at the Chamber office.

Print the form, fill out and mail to the address at the end of the form along with payment as required.

 

Event Name: ____________________________________________

Event Date: _____________________________________________

Enclosed is my check for $ ______
or
Payment by: ____ VISA ____M/C _____ Discovery

Account # ___________________________ Exp Date ________

Security Code (V Code) ______ Zip Code___________

Name: __________________________________________ Member: Yes / No

Name: __________________________________________ Member: Yes / No

Name: __________________________________________ Member: Yes / No

Name:__________________________________________ Member: Yes / No

Company: ____________________________________________

Address: _____________________________________________

City, State Zip: _________________________________________

Phone: _________________ Fax: ___________________

Email: _______________________________________

No Refunds. See Event Flyer/Event Page for registration deadline


Make check payable to: Metuchen Area Chamber of Commerce
323 Main Street Suite B, Metuchen, NJ 08820
732.548.2964 / 732.548.4094 fax
mailto:metuchen.chamber@verizon.net