Black Networking Event Registration Form

Black Networking Mixer

Thursday, January 16, 2025 4:30pm-6pm The Studio @ the Appell Center for the Performing Arts
Name (will be shared with attendees)

First NameLast Name
Preferred Business Email (will be shared with attendees)
example@example.com
Business Phone (will be shared with attendees)
Please enter a valid phone number.
Address--Please use your home address. This information will NOT be shared with anyone. It will be used to create your Appell Center account and register you for this event.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
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Black Networking Mixer