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1061 Atlantic Avenue · Brooklyn, NY 11238 · (718) 638-NEWS · Fax (718) 638-1810 · www.BlackChurchMeansBusiness.com
A CHRISTIAN TIMES AND ECONOMIC LITERACY COALITION EVENT December 11 & 12, 2006 - Brooklyn Museum
R E G I S T R A T I O N CLASSIFICATION MR. MRS. MS. REV. DR.
PASTOR ELDER BISHOP ARCHBISHOP OTHER ________
CLERGY FIRST NAME
LAST NAME
ENTREPRENEUR EXHIBITOR
COMPANY/ORGANIZATION (if any)
MEDIA PARTICIPANT
ADDRESS
APT / SUITE
SPONSOR YOUTH
CITY
(
STATE
)
(
DAY PHONE
)
EVENING PHONE
A 2 days
B 1 day
$65 per person
$55 per person
Group of 5 or more: $55 per person
Group of 5 or more: $45 per person
LATE REGISTRATION (After November 27th) $85 per person
LATE REGISTRATION (After November 27th) $75 per person
Group of 5 or more: $70 per person
C
ZIP
Group of 5 or more: $60 per person
Youth Admission Scholarship Ages 10 thru High School
E-MAIL
Area(s) of Interest Franchising & Corporate Dealerships Banking and Financing
P A Y M E N T 2 DAYS
1 DAY
Food and Grocery (Day 2 only) Investing & Managing Finance Supplier Diversity and Procurement
=$ # of persons
Real Estate Development (Day 2 only) Business of Fashion & Retailing (mainly Day 1)
=$ # of persons
TOTAL:
=$ # of persons
METHOD OF PAYMENT VISA
MASTERCARD
AMEX
CHECK
CASH/M.O.
FOR OFFICE USE ONLY
CREDIT CARD #
EXPIRATION DATE
CARDHOLDER’S SIGNATURE
PRINT NAME (as it appears on credit card)
Web Download Brooklyn Fashion Gallery
A CHRISTIAN TIMES AND ECONOMIC LITERACY COALITION EVENT December 11 & 12, 2006 - Brooklyn Museum
R E G I S T R A T I O N CLASSIFICATION MR. MRS. MS. REV. DR.
PASTOR ELDER BISHOP ARCHBISHOP OTHER ________
CLERGY FIRST NAME
LAST NAME
ENTREPRENEUR EXHIBITOR
COMPANY/ORGANIZATION (if any)
MEDIA PARTICIPANT
ADDRESS
APT / SUITE
SPONSOR YOUTH
CITY
(
STATE
)
(
DAY PHONE
)
EVENING PHONE
A 2 days
B 1 day
$65 per person
$55 per person
Group of 5 or more: $55 per person
Group of 5 or more: $45 per person
LATE REGISTRATION (After November 27th) $85 per person
LATE REGISTRATION (After November 27th) $75 per person
Group of 5 or more: $70 per person
C
ZIP
Group of 5 or more: $60 per person
Youth Admission Scholarship Ages 10 thru High School
Area(s) of Interest Franchising & Corporate Dealerships Banking and Financing
P A Y M E N T 2 DAYS
1 DAY
Food and Grocery (Day 2 only) Investing & Managing Finance Supplier Diversity and Procurement
=$ # of persons
Real Estate Development (Day 2 only) Business of Fashion & Retailing (mainly Day 1)
=$ # of persons
TOTAL:
=$ # of persons
METHOD OF PAYMENT VISA
MASTERCARD
AMEX
CHECK
CASH/M.O.
FOR OFFICE USE ONLY
CREDIT CARD #
EXPIRATION DATE
CARDHOLDER’S SIGNATURE
PRINT NAME (as it appears on credit card)
Web Download Brooklyn Fashion Gallery
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