Business Referral Group Inquiry - Capital Region Chamber

Business Referral Group Application

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

First Name*

Last Name*

Company Name*

Title/Position*

Address*

City, State, Zip*

Email*

Phone*

Industry Type*

Specialty/Focus*

How did you hear about BRG?*

Attendance is integral to the success of every Business Referral Group. Based on the meeting details listed on the BRG page please indicate all groups you would like to be considered for (please limit 3 choices):

BRG #1

BRG #2

BRG #3

BRG #4

Who/What is a good referral for you?*

What types of businesses can generate referrals to you?*

What added value can you provide to this referral group?*

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