Breakfast Meeting REservation Form
If you would prefer to pay via paper check, please click here for a printable version of this application to mail in along with your check.

Items in red are required for new members.

Type of membership     (Name only is required if all other information is unchanged)
Name:
Parish:
Occupation:
Company:
E-mail:
Street Address:
City:
State:
Postal/Zip Code:
Work Telephone: Enter as "5591234567"
Home Telephone: Enter as "5591234567"
Cellular Telephone: Enter as "5591234567"
  I prefer paperless correspondence by e-mail.
  My Company may advertise in the Annual CPBC Directory.
        Contact:  
  Please do not publish my personal information in the Directory
Important Notes/Comments:

If you would prefer to pay via paper check, please click here for a printable version of this application to mail in along with your check.

For additional information, click here to contact us or call John Kanaley (315) 243-6597 .

 

"FAITH - ETHICS - AND BUSINESS - NEED NOT BE MUTUALLY EXCLUSIVE"