Clone of 2025 KWN Regular Business Member

2026 KWN Regular Business Member

To register as a Kenosha Women's Network business member, please complete all questions.
Name of Business*
Business Type*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Website
Any one or all designated KWN members are welcome to attend luncheon meetings.
Designated Member #1
Name*

First NameLast Name
Title*
E-mail*
example@example.com
KWN newsletter, notices of upcoming events, and other important information will be communicated by email.
Phone Number*
Format: (000) 000-0000.
Phone number is (please choose one):*

CellHomeWork
Designated Member #2
Name*

First NameLast Name
Title*
Email*
example@example.com
KWN newsletter, notices of upcoming events, and other important information will be communicated by email.
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Phone number is (please choose one):*

CellHomeWork
Designated Member #3
Name

First NameLast Name
Title
Email
example@example.com
KWN newsletter, notices of upcoming events, and other important information will be communicated by email.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Phone number is (please choose one):

CellHomeWork
Designated Member #4
Name

First NameLast Name
Title
Email
example@example.com
KWN newsletter, notices of upcoming events, and other important information will be communicated by email.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Phone number is (please choose one):

CellHomeWork
Designated Member #5
Name

First NameLast Name
Title
Email
example@example.com
KWN newsletter, notices of upcoming events, and other important information will be communicated by email.
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Phone number is (please choose one):

CellHomeWork
How did you find out about KWN?*
Get Involved! Check all areas of interest!

Board MembershipEventsHospitality/MembershipCommunications/NewsletterOther
Signature
Signature Date*

MonthDayYear
Date
By completing and signing this form, you are agreeing to let KWN use your name/and or picture on marketing and promotional items to include, but not limited to, flyers, posters, social media pages, ads, emails, etc.

My Products*

Should be Empty:

2026 KWN Regular Business Member

Any one or all designated KWN members are welcome to attend luncheon meetings.

Credit Card