MEMBERSHIP, CONTRIBUTIONS, & EVENT REGISTRATION

Thank you for registering on-line.
Should you have questions or problems submitting your contribution, membership application or event registration, please contact: Cathy Tracy, Business Manager at (860) 951-6161 ext. 14

Name   
Billing Address   
Town   State   Zip Code  
Telephone   10 digits, no parenthesis, dashes or spaces required.
Credit Card   AMEX - 15 digits/ VISA & MasterCard 16 digits. No spaces required
Expiration
  mmYYYY  V Code  
AMEX - 4 digits on front
VISA & MasterCard - 3 digits on back

By entering your credit card number, you authorize Leadership Greater Hartford to charge your account.

EVENT REGISTRATION:

2008 Polaris Awards - $100 per person    No. of Tickets 

Total $
MEMBERSHIP:


 

As a dues-paying member of the LGH Network, you will be extended a number
of benefits for the entire year. Other than Leadership Circle, all memberships are renewable on an annual basis. Membership dues are separate from contributions to the LGH Development Fund.

* Golden Membership  - is reserved for LGH program graduates over the age of 65 or graduates of the Third Age Initiative. 

** Specialty Membership Packages - offer a number of exclusive benefits in addition to those extended to annual members.

Total $

Yes! I would like to help build community leadership in Greater Hartford by supporting the Leadership Greater Hartford Development Fund with a tax-deductible gift of:  

Please dedicate my gift to support:    


 
 
(Other Amount)
 
$
(Including membership, event registration and/or contributions)
By submitting your credit card number, you are authorizing
Leadership Greater Hartford to charge your account
.

TOTAL AMOUNT  
$  

DEVELOPMENT FUND:
Comment/Question



LGH updates this page on a regular basis. If you experience difficulty submitting your RSVP and/or
payment online, please  to contact Cathy Tracy, Director of Finance & Operations at (860) 951-6161 ext. 14.

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