Membership Application

Renewal	New

Name
Business Name
Mailing Address
City
State	Zip Code
Business Telephone	Business Fax
Cell	Home Telephone
E-mail Address
Website Address
Business Category (i.e., Antiques, Printer, Architect, Special Events, Merchant Services, etc.
Yearly Membership: Individual Membership includes 1 member and 1 guest: $100 Business Membership 1-3 employees, includes 1 member and 1 guest: $100 Business Membership 4+ employees, includes 1 member and 2 guests: $150
Payment Instructions: If paying with a credit card, please contact ELIE Treasurer at one of the meetings. If paying with a check, please make your check payable to ELIE and mail to ELIE - Membership, P.O. Box 696, Riverhead, NY 11901-0502.
Meeting Details: Cost for Paid Members with reservations is $30; Cost for Members without reservations and all others is $40 at the door. No reservations accepted after 12 noon on day of dinner meeting. Members with reservations will take priority if seating become limited.

President 2007-2008: Robert Dubester