Hollywood Monthly mixer

Hollywood Chapter Monthly Mixer Registration Form
Name *

First Name Last Name
Business Name *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *
E-mail will be used to keep you updated with the chamber *
example@example.com
How did you hear about this mixer?
My Products *
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Current SCBCC members Free Southern California Black Chamber of Commerce paid member
Free

Cash/ in person payment If paying by cash in person, please select this box
Free

Mixer Registration for non-members
$ 10.00 Quantity

Vendor Space- Current Member
$ 15.00

Vendor Space - Non- Member
$ 25.00

Total

$ 0.00
Do you need special accommodation to participate in this meeting? If so, please list them below and someone will reach out to you.
I agree to {terms & conditions}. *
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Hollywood Chapter Monthly Mixer Registration Form