Which Meeting Are You Planning On Attending?
 Commack on Monday Mornings    Bellport on Tuesday Mornings

Business Name:

Contact:     Type Business:

Complete Address:

Tel: No:       Fax No.       Email Address:

Email:       Web Address      

Best Time To Contact Me:

Referred By:

My products and/or Services:

Note:
   *     If a member misses 3 meeting in a row without extenuating circumstances, their business category
         sponsorship will be vacated and made available to new members
   **    This is No Membership Fee to join this group, but we do collect $2.00 at each meeting to cover group expenses.
   ***   Breakfast orders at the meetings are by separate check. Please include a 20% gratuity for the waitress.
   ****  All memberrship applications are subject to approval of the Board of Directors