Reservation Form

Welcome to the Women's Leadership Circles at JBN RSVP Form

UPCOMING EVENT WEDNESDAY, DECEMBER 4th, 2025, 6:30 PM
400 BROADHOLLOW RD, MELVILLE, NY 11747
For more information call (631)-827-6599
Full Name
First Name Last Name
Company Name
Primary Contact Title

Address

E-mail
Phone Number
Web Site Optional
Business Type
Choose one - optional
Professional
Financial
Trades
Business
To suggest a new category please email [email protected]
Business Description Optional
Please limit your description to 75 characters.
Register for the upcoming event (RSVP today to ensure a spot)
Registration Options

RSVP: Member - $0RSVP: Non-Member: $100RSVP with Promo CodeCorporate Sponsorship - Click option belowTake a table: Includes you plus 5 guests - $360Annual Membership - Includes all events with a guest - $1000
Promo code
Amount to charge (if using promo code)
*Members can bring a guest at no charge. Those taking a table, can bring 5 guests.
1) Name
First Name Last Name
1) Company
2) Name
First Name Last Name
2) Company
3) Name
First Name Last Name
3) Company
4) Name
First Name Last Name
4) Company
5) Name
First Name Last Name
5) Company
Corporate sponsorship opportunity

Silver: $2000Gold: $3000Diamond: $5000
Sponsorship gives you an unparalleled opportunity to showcase your business directly in front of JBN's elite group of LI top CEOs and business leaders.
Credit Card Information
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Credit Card Number
Exp: Month
Exp: Year
CVV
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