AzBizGreen Registration

Arizona Minority Business Enterprise Center
A Federally Funded Program by the Minority Business Development Agency, U.S. Dept. of Commerce.

Locally operated by the Arizona Hispanic Chamber of Commerce
255 East Osborn Road, Suite 202; Phoenix AZ 85304. Phone: 602-248-0007

AzBizGreen 2010 Registration Form

October 7, 2010
Glendale Civic Center
5750 W. Glenn Drive, Glendale AZ 85301

When you submit this form, we will contact you via phone for the payment. You may pay with a credit card over the phone at 602-248-0007. If paying by check, please mail your check to: AzBizGreen - AMBEC, 255 E. Osborn Road, Suite 202, Phoenix AZ 85012.

We look forward to seeing you!

Organization Information

Company Name:
Company Address:
City, State & Zip Code:
Contact's Name:
Contact's Email:
Business Phone:
Mobile Phone:
	Free Ticket
	$7,500 Sponsorship: Includes Speaking role + 20 tickets to the event
	$5000 Sponsorship: Includes 10 tickets to the event
	$3,500 Sponsorship: Includes 5 tickets to the event
Purchases	$2,500 Sponsorship: Includes 4 tickets to the event
	$1,000 Sponsorship: Includes 3 tickets to the event
	$500 Sponsorship: Includes 2 tickets to the event
	Vendor Table $250: Includes 2 tickets to the event

$2000	Full Page Advertisement in the Program ($2000)
$1000	Half-page Advertisement in the Program ($1000)
$500	Quarter Page Advertisement in the Program ($500)
$50	Business Card Size Ad in Program:$100
Preferred Payment Method	Discover
	AMEX
	VISA
	MasterCard
	Check Mail to: AzBizGreen - AMBEC, 255 E. Osborn Road, Suite 202, Phoenix, AZ 85012
Card Number:
Expiration:
Topics of Interest:
Comments: