East Bay Women's Network - Membership Application

Membership Application

Membership fees are only $90 for the year. To join complete this E-form and click on the "Submit" button below - or - contact Lauren Devine, Membership Chair, (510) 755-0528, . Please bring your membership dues to our next meeting, the first Wednesday of each month. To RSVP for monthly meetings contact Shirley Runco Shirley Runco at: (510) 278-3136

East Bay Women's Network Membership Application:

First Name*
Last Name*
Business Type*
Business Address*
City, State, Zip*
Phone*
*Fax (leave blank if none)**
Birthday*
Occupation*
Type of Business*
What category would your business fall under?*
E-mail*
Web site
How did you hear about EBWN?*
What would you like to get out of EBWN?*
Are you interested in a leadership role in EBWN?*
	Highlight this text and tell us more about you and your business
* (required information)