Please complete all four sections below to make your reservation

1. Name:       Company:       Phone

:

(     )     -      Email:      

Business

Category:

     

LBN Chapter:       Non-Members: Name of LBN Member who invited

you:

     

2. Exhibitor:Exhibitor 4’ Table LBN or FON Member: $50.00

- Table top presentation space Non-Member: $75.00 - Table and cover Exhibitor 8’ Table LBN or FON Member: $80.00 - 4 hours of Networking Non-Member: $105.00 - Continental breakfast for 1 person Electricity Needed: $0.00 - Electricity if ordered Offering Door Prize: $0.00 - Door Prizes *Add $10 late fee if registering after February 9thth: $10.00

- 4 hours of Networking- Continental breakfast for 1 person Name of Staff:       - Door Prizes Email:      

Non-Exhibitor: - 4 hours of Networking

- Door Prizes Non-Exhibitor: $15 each

- Continental breakfast for 1 person

Lunch & Networking: - 12:15 pm – 2:00 pm Total Lunch price ($20 per person):      - $20 per person *If person attending lunch is different than or in addition to those

named above, please call 248-620-6320.

3. PAYMENT OPTIONS

CHECK CREDIT CARD Total Amount:      

CARD TYPE: VISA M/C DISCOVER AMERICAN EXPRESS

Name as it appears on card      

Billing Address                     STREET CITY STATE ZIP

Card Number       -       -       -       Security Code:     

Expiration Date:    /      Signature      Date     

4. To complete your reservation, do one of the following:

Second Staff Member at Exhibit: 2nd Staff Member at Exhibit: $15 each

LBN WinterMixer

Club Venetian 29310 John R, Madison Heights, MI 48071

Thursday, February 17th 8AM to Noon

JOIN US FOR ONE OFJOIN US FOR ONE OFSOUTHEASTERN MICHIGAN’SSOUTHEASTERN MICHIGAN’S

PREMIER NETWORKING EVENTSPREMIER NETWORKING EVENTS

- Mail form with your check made out to LBN: Local Business Network- Sign up online at www.LocBusNet.com 5446 Bristol Parke Dr. - FAX form with payment info. to (248) 620-6321 Clarkston, MI 48348

*All reservations must be received by February 11th.

No cancellations after that date. No-shows will be billed FOR ADDITIONAL INFORMATION CALL (248) 620-6320