Georgia Legislative Black Caucus, Inc.

2010 ALW

Bronze

Corporate Sponsor Form

Bronze Sponsor - $500

Reserved Table for (8) to luncheon.

Enter your Company Registration Information below.

Name:

Organization:

Mailing Address:

City:

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Zip:

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* = required fields

Make check payable to The Georgia Legislative Black Caucus, Inc.,
In memo section please list: 2010 ALW Registration
Mail check and form to
GLBC, Inc.
P.O. Box 38028, Atlanta, GA 30334
GLBC Tax exempt number: 58-1500919

Contact GLBC
GLBC Phone: (404) 651-5569 Fax: (404) 651-6984

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