RI CEO Council Membership

For health reasons there will be just six seats at each ten-seat table.

Please Provide All Information Requested

— All information provided will be kept confidential —

Select Event

Name & Date:

Your Name & Title:

Full Formal Name:

Name on Badge - First: Last:

Current Job Title:

The organization you lead:

Type of Organization

Org Name:

Address:

City: State: Zip:

Workforce Size: Number of Employees:

Number of Employees must be consistent with Workforce Size

Description of Business:

Business Website:

Your contact info:

email:

Office Phone (direct): Mobile:

Executive Assistant (optional):

First Name: Last:

email: Phone:

Preferred way for us to contact you:

Attendee Agreement:

I have read and agree to abide by the Rhode Island CEO Council's Member & Guest Principles:

eSignature:

Registration Fee:

(Includes a 30-day trial membership and seat reservation at the event you selected)

Qualified Chief Executive: $175 registration fee

Invited Guest of: (registration fee covered by member)

Any Special Needs?

ROBOT CHECK

Seat Reservation