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EcONOmic & cArEEr SummiT - US Black Chamber, Inc.

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You’re Invited....<br />

On behalf of the U.S. <strong>Black</strong> <strong>Chamber</strong>, <strong>Inc</strong>. (<strong>US</strong>BC), and our Western Regional headquarters, we invite you to<br />

join us for the first ever Solution Series Event. As part of the Greater Phoenix <strong>Black</strong> <strong>Chamber</strong> of Commerce<br />

(GPBCC) Annual Economic & Career Summit, this promises to be an exciting and highly enlightening professional<br />

development conference for small business owners and corporate professionals alike.<br />

The GPBCC Economic Summit is a premier educational event, and your vehicle for building the skills needed to<br />

successfully manage and grow your small business, secure a new job, access the tools necessary as you travel<br />

on your pathway to success. Now in conjunction with the <strong>US</strong>BC, this regional event is shaping up to be truly<br />

valuable, and is one that brings together the best of small business owners, chamber leadership, corporate<br />

partners and policy makers all the way from Washington D.C. to the Western United States, all in one place,<br />

and at one time!<br />

This two-day event will provide you with unprecedented educational and networking opportunities, including<br />

a host of dynamic speakers at plenary sessions and workshops. Information will be shared on successful approaches<br />

and strategies empowering your business to make national connections. Thanks to the commitment<br />

of our over100 African American chambers, programs and opportunities like this have been able to reach many<br />

more small minority businesses across the country.<br />

We hope that you, along with colleagues, will join us to be one of more than 400 corporate executives, government<br />

officials, chamber leaders, and business owners who will attend one of our biggest events of the year.<br />

Please share this opportunity with others in your organization that could benefit from attending the premier<br />

forum on minority business and economic development. Make the most of what this entire event has to offer.<br />

Finalize your plans and send in your registration form today!<br />

On behalf of our both of our Board of Directors and Professional Development Committees, we thank you for<br />

your continued support and look forward to seeing you in Phoenix, AZ.<br />

In the Spirit of Success,<br />

Ron Busby Kerwin Brown<br />

President & CEO Chairman & CEO<br />

U.S. <strong>Black</strong> <strong>Chamber</strong>, <strong>Inc</strong>. The Greater Phoenix<br />

<strong>Black</strong> <strong>Chamber</strong> of Commerce


About the Summit<br />

The U.S. <strong>Black</strong> <strong>Chamber</strong>’s “Solution Series” promotes the<br />

connection of national, regional and local resources in our efforts to<br />

advocate for small business & economic development in minority<br />

communities. The intent is to increase awareness of our national<br />

footprint by focusing on the growth, efficiency, and influence of our<br />

agenda through education, training and the sharing of industry best<br />

practices.<br />

Through plenary sessions, workshops, webinars, and networking<br />

opportunities, our members and participants will walk away with the<br />

tools necessary to tackle the obstacles they face on their pathway to<br />

success.<br />

“A regional event...<br />

with national exposure”<br />

We pride ourselves on our diverse faculty, recruited from all over the<br />

United States. The line-up consists of a variety of seasoned<br />

governemnt officials, corporate executives, consultants, practitioners,<br />

and academics. These individuals bring a broad range of experience<br />

and knowledge to our Economic & Career Summit.<br />

This is a two day summit that focuses on:<br />

· Educating small business owners on how to become business<br />

ready<br />

· Training corporate employees on how to leverage one’s skills to<br />

climb the corporate ladder<br />

· Developing mentorships with those under and over 40 in<br />

preparation to pass the torch<br />

· Informing everyone about the latest public policy issues facing<br />

small business owners<br />

· Presenting innovative business solutions to help your business or<br />

organziaton operate more effectivly and efficiently<br />

· Leverage new contract opportunities for your business to take<br />

advantage of<br />

· Career placement and one-on-one coaching to help connect those<br />

organizations seeking to diversify their workforce.<br />

Who should attend the<br />

Summit?<br />

This event is designed for those with a<br />

strong interest in growing their organizations<br />

and professionals looking to advance<br />

their careers.<br />

The curriculum offers a broad range of<br />

courses, from how to start a small business<br />

to underutilized national programs<br />

on acces to capital.<br />

Specifically, this event is the ideal source<br />

of professional development and training<br />

for individuals on the following career<br />

paths:<br />

- Entry level positions<br />

- The “C-Suite” and Executive Staff<br />

- Board Members<br />

- Administrative Officers<br />

- Human Resource Managers<br />

- Finance Managers/Directors<br />

- Program Managers/Directors<br />

- Technology Officers/Managers<br />

- Marketing Managers/Directors<br />

- Development Officers/Managers<br />

- Communications Officers/Managers<br />

Sample Summit Agena<br />

DAY ONE<br />

8:00 am On-site Registration<br />

8:30 am Welcome from the President<br />

9:00 am Morning Motivation<br />

9:30 am Classes<br />

12:00 noon Luncheon & Expo<br />

2:30 pm Classes<br />

5:30 pm Reception<br />

DAY TWO<br />

8:00 am Expo & Job Fair featuring:<br />

career placement; resume<br />

proofing; mock interviews;<br />

Raffles; <strong>Black</strong> <strong>Chamber</strong> Live<br />

TV; “Mob our Members”<br />

continuing education, life<br />

coaching & professional<br />

headshots; and a “high noon<br />

fashion show”<br />

5:00 pm Expo Closes<br />

6:00 pm Live Concert & Reception


About the U.S. <strong>Black</strong> <strong>Chamber</strong>, <strong>Inc</strong>.<br />

MISSION STATEMENT<br />

The U.S. <strong>Black</strong> <strong>Chamber</strong>, <strong>Inc</strong>. (<strong>US</strong>BC) provides committed, visionary leadership and<br />

advocacy in the realization of economic empowerment. Through the creation of resources<br />

and initiatives, we support African American <strong>Chamber</strong>s of Commerce and business<br />

organizations in their work of developing and growing <strong>Black</strong> enterprises.<br />

VISION STATEMENT<br />

<strong>US</strong>BC is an association of over 100 self-sustaining, viable <strong>Black</strong> <strong>Chamber</strong>s and small<br />

business associations nationwide whose collaboration with strategic partners increases<br />

our capacity to serve.<br />

VALUE PROPOSITION<br />

We strive for excellence in our organizational operations by focusing on integrity,<br />

credibility, and adding value to our clients.<br />

About the Greater Phoenix <strong>Black</strong> <strong>Chamber</strong><br />

MISSION STATEMENT<br />

The mission of the Greater Phoenix <strong>Black</strong> <strong>Chamber</strong> of Commerce (GPBCC) is to improve the economic<br />

development of our business entrepreneurs and the communities we serve. The GPBCC serves as the cornerstone<br />

for educational training, resource programs, resources and economic growth opportunities with a<br />

specific emphasis on “Business In Action”.<br />

We exist to facilitate the economic empowerment of the Greater Phoenix <strong>Black</strong> community and our<br />

<strong>Chamber</strong> members through the promotion of entrepreneurship on a variety of levels, including but not<br />

limited to:<br />

• Offering leadership and advocacy in efforts regarding economic, political and social issues<br />

• Facilitating relationships between <strong>Chamber</strong> members, existing <strong>Black</strong>-owned businesses; and the<br />

Greater Phoenix corporate community<br />

• Attracting local, national, and international business opportunities for <strong>Black</strong>-owned enterprises<br />

• Educating our membership in the most current productive and efficient business practices<br />

• Assisting whenever possible in the cultivation of fledging <strong>Black</strong>-owned enterprises<br />

• Acting as a clearinghouse for information, opportunity and dialoge


ADVOCACY<br />

The <strong>US</strong>BC fights for legislation that<br />

promotes small business growth,<br />

particularly policies that address the<br />

challenges of <strong>Black</strong> business owners.<br />

We understand the importance of<br />

maintaining a bipartisan approach to<br />

advocacy, and hence, collaborate with<br />

policy makers from all political affiliations<br />

to advocate for policies that best<br />

serve the interest of the <strong>Black</strong> community.<br />

ACCESS TO CAPITAL<br />

Capital access remains the most important<br />

factor limiting the establishment,<br />

expansion and growth of <strong>Black</strong>owned<br />

businesses. The <strong>US</strong>BC works<br />

with financial institutions, particularly<br />

<strong>Black</strong>-owned institutions, to create avenues<br />

by which <strong>Black</strong> businesses can<br />

gain greater access to credit, capital<br />

and other financial instruments.<br />

CONTRACTING<br />

At the <strong>US</strong>BC, our goal is to level the<br />

playing field by helping members gain<br />

access to business opportunities in<br />

private and public sectors. We accomplish<br />

this by educating members<br />

on contract opportunities, helping<br />

them increase their capacity to bid for<br />

large scale contracts, and offering resources<br />

and information that enhance<br />

<strong>Black</strong> owners’ ability to compete.<br />

ENTREPRENEUR TRAINING<br />

The <strong>US</strong>BC is committed to helping<br />

<strong>Black</strong> business leaders achieve stellar<br />

performance and growth through entrepreneur<br />

and business management<br />

Our National Footprint<br />

The infrastructure of the <strong>US</strong>BC allows for a quick mobilization of messaging and support in all 50 states. National policy<br />

positions are finalized in our Washington, DC headquarters, and then filtered throughout the country by five Regional Directors<br />

that ensure and support the delivery of messaging to our 100+ <strong>Black</strong> <strong>Chamber</strong>s and Business Associations. Our mobilization includes<br />

highly targeted communications from chamber leaders to local business, community leaders, elected officials and policy staff.<br />

We take pride in our ability to influence policy by generating letters of support, calls, and face-to-face meetings with key<br />

decision makers at the local, state, and federal levels as it relates to <strong>Black</strong> and small businesses.<br />

[ Five Pillars of Service ]<br />

The <strong>US</strong>BC’s Five Pillars of Service are the cornerstone of our platform. They represent issues that greatly impact the<br />

growth of <strong>Black</strong>-owned businesses in America and consequently, form the foundation of the <strong>US</strong>BC’s agenda.<br />

training. Hence, we deliver quality<br />

educational opportunities and professional<br />

development resources that<br />

help our members manage and grow<br />

successful businesses.<br />

B<strong>US</strong>INESS DEVELOPMENT<br />

The growth and development of <strong>Black</strong><br />

chamber members, businesses and individuals<br />

is a core focus of the Greater<br />

Phoenix <strong>Black</strong> <strong>Chamber</strong> of Commerce.<br />

As such, we leverage our role as a regional<br />

organization, provide technical<br />

assistance and leadership training to<br />

members, and facilitate the sharing<br />

of best practices and industry data<br />

among our members. To do this, we<br />

utilize a variety of mechanisms including,<br />

training, web-based tools, peer<br />

networking, coaching, and information<br />

products.


[ PhoEnIx, AZ ]<br />

<strong>EcONOmic</strong> & <strong>cArEEr</strong> <strong>SummiT</strong><br />

MAking CoAST To CoAST ConneCTionS<br />

A · G · E · N · D · A<br />

Thursday | 11.8.12<br />

8:45am WArm uP AND mOTiVATiON EXErciSE | The Generative<br />

Action Process That Takes A Dream To Reality<br />

FEATURING: Dr. Joel martin, Positively Powerful Women<br />

9:30am uSBc POWEr PANEL | Access to Capital. Small business owners need capital to<br />

fuel their product launch, add new business lines, and expand into new markets. This panel<br />

will show case presenters from all across the country who represent a wide range of financing<br />

programs, that will provide you with the fuel you need to grow your enterprise!<br />

11:15am Morning Break<br />

11:30am BrEAKOuT SESSiONS<br />

ENTrEPrENEur TrAiNiNg | GPBCC Entrepreneurial Training Program<br />

BuSiNESS DEVELOPmENT | Organizational vs Personal Branding. Learn to<br />

master the business of YoU! What impression do people walk away with when they interact<br />

with your brand online? How does your reputation stack up? Are you perceived the way you<br />

would like to be perceived? What compelling reason do you give people to choose brand YoU?<br />

For organizations, the message is no different! Your employees are your most organic channel<br />

of marketing, educating them in the art of Personal Branding can unleash results impossible<br />

through traditional media.<br />

FEATURING: robert Van Arlen, Speaker, Author, Coach<br />

YOuNg ENTrEPrENEurS | The 1, 2, 3’s of Starting A Business. Before you<br />

make the decision on whether or not you should take the plunge and go into business for<br />

yourself, there are a number of very basic questions that you should have first considered<br />

very thoroughly, which may help you to decide whether or not you are ready to start a particular<br />

business. This introductory session is designed to alert you to a number of key points<br />

you may not have considered yet, as well as assist you in dealing successfully with some of<br />

the initial problems you will face.<br />

FEATURING: rod mcKiinnes, Partner, Research Based Solutions | Fola Odejimi, Financial<br />

Planner, The Odyssey Group


12:30pm LuNcHEON & uSBc POWEr PANEL | “One Community”…<br />

Joint Ventures and Sub Contracting Opportunities With Other<br />

Minority Groups. our panel will not only share practical perspectives on why and<br />

how to form partnerships, what partners look for, and leveraging agreements and<br />

joint ventures; they will also discuss future project opportunities for you to<br />

maximize and capitalize.<br />

2:30pm BrEAKOuT SESSiONS<br />

3:30pm Break<br />

MODERATED BY: commissioner Sandra D. Kennedy, Arizona Corporation Commission<br />

ENTrEPrENEur TrAiNiNg | A Healthy Workforce Should Lead to a<br />

Healthy Economy. This workshop is the first step on the path of personal responsibility<br />

for our individual and collective health and well-being. YYou will learn quick and easy stress<br />

reduction techniques to implement at the office, improve quality of life as well as bottom-line<br />

results, by learning how to handle stress before it handles you!<br />

FEATURING: maria mitchell, Acute Care Managment Supervisor, Mercy Care Plan |<br />

Tomás León, Chief Executive Officer, People of Color Network | Stephan E.<br />

Dannenbaum, Ph.D., Director of Integrated Health and Analytics, Magellan<br />

Health Services.<br />

BuSiNESS DEVELOPmENT | Board Development. organizations are<br />

becoming more adept at planning, but have not simultaneously learned to orchestrate<br />

and lead their organizations and people through the inevitable changes that must take<br />

place. This workshop gives leaders the tools to understand the change process and the<br />

framework for leading their agency and its people through the cycle of change.<br />

FEATURING: Karl gentles, President, KG Public Relations | Dana campbell Saylor,<br />

Chief Executive Officer, YWCA<br />

YOuNg ENTrEPrENEurS | Mentorship Programs. good mentoring depends on<br />

having a collaborative, reciprocal learning relationship with your mentor. There are several<br />

basic questions that you should ask, which may help you decide whether or not you are ready<br />

to start a particular business. This introductory session is designed to alert you to key points<br />

that you may not have considered yet, as well as, assist you in successfully addressing some<br />

of the initial changes that you may encounter.<br />

FEATURING: roxanne Banks, Regional Director, INROADS | Todd Weinstein, Director<br />

Leadership Development, PetSmart<br />

3:45pm BrEAKOuT SESSiONS<br />

ENTrEPrENEur TrAiNiNg | Operation Know How...the in’s and out’s of<br />

Business Law & Contracting & Licensing. knowledge of the general principles of contract<br />

law is important especially to clarify and facilitate commerce. This workshop will expose<br />

participants to the fundamentals of contract law, and assist in understanding customs and best<br />

practices in contracting and the licensing needed to get you ready to compete.<br />

BuSiNESS DEVELOPmENT | Where Are You In Your Insurance and Risk<br />

Managment Plan? Are your insurance costs too high? Master all the insurance and risk<br />

management facts, strategies and how-to techniques you need to gain full, confident control<br />

of your program! In this workshop you will learn everything you must know about coverage,<br />

cost, liability limits, retention and broker services/compensation. Be sure to bring your company<br />

policy—and your questions—for discussion!<br />

YOuNg ENTrEPrENEurS | Financial Literacy...Get Your Busniess Started.<br />

Many people who want to start a business cannot reach their goal because of poor credit, lack of<br />

savings and a lack of understanding about the basics of money management. Come and learn<br />

the basics of banking, credit, financial planning, money management and saving and investing.


4:30pm<br />

Friday | 11.9.12<br />

TOWN HALL | Why <strong>Black</strong> <strong>Chamber</strong>s? In order for our communities<br />

to grow, there must be strong black businesses. in order for black businesses<br />

to grow, there must be strong black chambers. America’s economic future is so<br />

inextricably linked with minority and immigrant groups that investment in black<br />

chambers of commerce is essential.<br />

MODERATED BY: Derek T. Dingle, Senior Vice President/Editor-In-Chief,<br />

BLACK ENTERPRISE Magazine<br />

5:30 - 7:30pm Networking Reception<br />

9:00am - 5:00pm EXPO & <strong>cArEEr</strong> FAir<br />

[FREE AND OPEN TO THE PUBLIC]<br />

will feature: Career Placement opportunities | Raffles | <strong>Black</strong> <strong>Chamber</strong> LiVe TV Show<br />

“High noon Fashion Show” | Live Twitter updates | “MoB oUR MeMBeRS” | Life coaching<br />

Professional Headshots | Resume Proofs | Mock interviews.....and much more!<br />

2:00pm - 3:00pm SmALL AND mEDium SizED BuSiNESS<br />

EDucATiON AND PrOFESSiONAL<br />

DEVELOPmENT STrATEgY.<br />

if you want to join the more than 14 million self-employed Americans (Bureau of Labor<br />

Statistics 2011), then the Bachelor of Science in Business with a concentration in Small<br />

Business Management and entrepreneurship* degree program can help you gain valuable<br />

know-how. With coursework that includes advanced concepts in small business development,<br />

communications and management theory, you’ll be preparing to lead. Learn how University of<br />

Phoenix can help you prepare for the dynamic world of entrepreneurship. Also, we are<br />

developing programs and new products to serve this market across the United States.<br />

3:00pm - 4:00pm BuSiNESS TrAVEL SOLuTiONS SEmiNAr<br />

At United, we offer travel discounts and reward programs to individuals, groups, organizations<br />

and small to mid-sized enterprises interested in partnering with United to better manage travel<br />

spend while earning savings and rewards. We are committed to finding ways to bring added<br />

value when you travel.<br />

5:00pm PrE-SHOW<br />

6:00pm - 10:00pm Concert Under The Stars<br />

FEATURING GRAMMY NOMINATED ARTIST<br />

Johnny Britt<br />

with special apperances by n’dambi Blue & Marion Meadows<br />

produced by:


[SPonSorShIP oPPorTUnITIES]<br />

TITLE SPONSOR<br />

$40,000<br />

This exclusive Phoenix sponsorship level<br />

includes...<br />

1) Exclusive branding of Concert<br />

Under the Stars<br />

- Opportunity to deliver sponsor remarks<br />

prior to live performace at Concert<br />

- Corporate logo on concert tickets<br />

- Company name & logo included on all<br />

media impressions ( over 30,000 national<br />

impressions in radio, newspaper, and<br />

social media outlets)<br />

2) Premier Placement at Summit<br />

- Corporate logo on all event marketing<br />

collateral<br />

- Full inside cover-page ad in event<br />

program<br />

- Corporate ad to be displayed on main<br />

screen (as part of event powerpoint<br />

video)<br />

- Company logo on website<br />

- Opportunity to deliver welcoming<br />

remarks from the podium on Thursday<br />

- Opportunity to sponsor/present a<br />

workshop*<br />

- Opportunity to display organizational<br />

product, service or opportunity at the<br />

Expo & Job Fair (includes 2 eight foot<br />

tables in prime location)<br />

- (30) complementary full registrations<br />

and (30) reserved seats at the Luncheon<br />

& Concert<br />

- Opportunity to sponsor / brand Summit<br />

Registration Bags<br />

- Recognition in the both the <strong>US</strong>BC<br />

President’s Message & the GPBCC News<br />

& Events newsletter<br />

- Sponsorship of (5) regional chamber<br />

leaders & their top business owner<br />

- One-on-one match-making opportunity<br />

with local top business owners<br />

- 12 Month Membership in both the <strong>US</strong>BC<br />

& GPBCC<br />

GOLD SPONSOR<br />

$10,000<br />

- 12 month membership in the GPBCC<br />

- Corporate logo on all event marketing<br />

collateral<br />

- Company name & logo included in all<br />

regional media impressions ( over 10,000<br />

national impressions in radio, newspaper,<br />

and social media outlets)<br />

- Full-page ad in event program<br />

- Corporate ad to be displayed on main<br />

screen (as part of event powerpoint<br />

video)<br />

- Company logo on website<br />

- Opportunity to sponsor and present in a<br />

workshop*<br />

- Opportunity to display organizational<br />

product or service at the Expo (includes<br />

2 eight foot tables; power and wifi will<br />

come at an additional cost)<br />

- (10) complementary full registrations<br />

and (10) reserved seats at the Luncheon<br />

& Concert<br />

- Sponsorship of (1) regional chamber<br />

leader & their top business owner<br />

- One-on-one match-making opportunity<br />

with local top business owners<br />

- Opportunity to provide branded keepsake<br />

for participants<br />

Silver Sponsor<br />

$5,000<br />

- Corporate logo inclusion on promotional<br />

event marketing collateral and event<br />

program<br />

- Corporate ad to be displayed on main<br />

screen (as part of event powerpoint<br />

video)<br />

- half-page ad in event program<br />

- Company logo on website<br />

- Opportunity to present in a workshop*<br />

- Opportunity to display organizational<br />

product or service at the Expo (includes<br />

1 eight foot tables; power and wifi will<br />

come at an additional cost)<br />

- One-on-one match-making opportunity<br />

with local top business owners<br />

- (5) complementary full registrations<br />

and (5) reserved seats at the Luncheon<br />

& Concert<br />

CORPORATE SPONSOR<br />

$3,000<br />

- Corporate logo inclusion on promotional<br />

marketing collateral and event program<br />

- Opportunity to display organizational<br />

product or service at the Expo (includes<br />

1 eight foot tables; power and wifi will<br />

come at an additional cost)<br />

- (4) complementary full registrations<br />

and (4) reserved seats at the Luncheon<br />

& Concert<br />

ExPO VENDOR<br />

$500<br />

- Recognition in promotional marketing<br />

collateral and event program<br />

- Opportunity to display organizational<br />

product or service at the Expo (includes<br />

1 eight foot table and 2 chairs; power<br />

and wifi will come at an additional cost)<br />

- (2) complementary full registrations<br />

and (2) reserved seats at the Luncheon<br />

& Concert


[rEGISTrATIon InForMATIon]<br />

FULL REGISTRATION $75<br />

[Price increases to $100 after Friday, October 19th. ]<br />

Full conference registration fees cover your attendance at the summit; (1) ticket to the concert on Friday ; conference<br />

materials and session handouts; daily meals including morning and afternoon refreshments, luncheons and<br />

receptions.<br />

SUMMIT REGISTRATION ONLY $60<br />

CONCERT TICKETS ONLY $40<br />

[hoTEl ACCoModATIonS]<br />

Overnight accommodations can be arranged through: the marriott at mcDowell mountains<br />

16770 North Perimeter Drive | Scottsdale, AZ 85260 at the rate of: $159.00 per room (all rooms are suites).<br />

reservations must be made by Wednesday, October 24th, 2012.


R E G I S T R A T I O N F O R M<br />

Please completed and return this form to Heather Holmes via fax at 602.307.5204-or- scan and email to<br />

heather@usblackchamber.org. Payments can be mailed to: The Greater Phoenix <strong>Black</strong> <strong>Chamber</strong> of Commerce | 1201 E. Washington<br />

St., Suite 350 | Phoenix, AZ 85004 | 602.307.5200 [p]<br />

I WOULD LIKE TO REGISTER FOR:<br />

FuLL rEgiSTrATiON (includes summit and concert)<br />

[ early bird pricing ]<br />

____ @ $75 | Non-Member fee<br />

____ @ $50 | Member fee<br />

Note: Deadline to register at this price is october 19th, 2012.<br />

[ registration after Friday, October 19th ]<br />

____ @ $100 | Non-Member fee<br />

____ @ $75 | Member fee<br />

<strong>SummiT</strong> rEgiSTrATiON ONLY<br />

____ @ $60<br />

cONcErT TicKETS ONLY<br />

____ @ $40<br />

PLEASE ACCEPT THIS COMITTMENT TO:<br />

BE A SPONSOr @ $_________________<br />

BE A EXPO VENDOr<br />

____ $500 | Vendor Fee<br />

____ $50 | internet ____ $35 | electrical power<br />

iN-KiND SPONSOr ( Please briefly describe your in-kind<br />

support and the associated value of this donation)<br />

_________________________________________________<br />

_________________________________________________<br />

ORGANIZATION INFORMATION<br />

Key Representative:<br />

Organization Name: ___________________________________<br />

Prefix ______ First Name:______________________________<br />

Last Name:__________________________________________<br />

Title:________________________________________________<br />

Address:____________________________________________<br />

___________________________________________________<br />

City:______________________________ State:___________<br />

Zip:____________ Direct Phone________________________<br />

Email:______________________________________________<br />

Website:_____________________________________________<br />

PAYMENT<br />

PLEASE iNVOicE mE AT THE ABOVE ADDrESS<br />

ENcLOSED iS A cHEcK iN THE AmOuNT OF<br />

$ ___________________ Check # _________________<br />

crEDiT cArD<br />

Card Type: VISA | MC | DISCOVER | AMEx<br />

Card : ______________________________________________<br />

Expiration Date: ____________ Security Code: _____________<br />

Signature: __________________________________________<br />

Should you have any questions, please contact Heather Holmes, Conference Coordinator at: 602.538.7500 [d] -or- heather@usblackchamber.org.

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