Register Me - Breakfast Forum

* denotes required field

*Name:


*Company:


Street Address:


*City:

State:   Zip:


*Phone:                                 Fax:
  

E-mail Address:


 
TO REGISTER, PLEASE CHOOSE THE APPROPRIATE BOX
Number of Tickets:
 
SEASON TICKET HOLDER - $18/Ticket
 
NORTH SHORE CHAMBER MEMBER - $25/Ticket
 
NON-MEMBER - $35/Ticket (must prepay by Credit Card)


PAYMENT -(Non-member: Payment by Mastercard, Visa, AMEX only) non-refundable, but transferable*

INVOICE ME (MEMBERS ONLY)

VISA:


MC:


AmEx:


Card Number:


Exp Date:

Comments:


checks: c/o North Shore Chamber of Commerce
5 Cherry Hill Drive Suite 100
Danvers, MA 01923
ph (978) 774-8565
fx (978) 7743418
www.northshorechamber.org


2007 Register Page is not secure. By pressing the Submit button, you are agreeing to these terms. If you wish to relay Credit Card information over the phone, please do so by calling (978) 774-8565.

© 2007 North Shore Chamber of Commerce. All rights reserved.