Your Name
Business Name
Welcome to Eastern Long Island Executives Business Roundtable
Promoting Business on Eastern Long Island
Please use this form to join or renew your membership
Street  or PO Box Mailing Address
City
State
Zip
Business Telephone
Business Fax
Cell
Home Phone
E-Mail
Website Address
Business Category
i.e., Antiques, Printer, Special Events, Merchant Services, etc.
Yearly Membership
Payment Instructions: If paying by check, please make check payable to ELIE.
Mail to ELIE - Membership, PO Box 696, Riverhead,  NY 11901-0502.

Cash and Checks are accepted at th edoor at ELIE meetings.
Option #1Option #2
Individual Membership includes 1 member and 1 guest: $100
Business Membership 1 employee, includes 1 member and 1 guest $150
Business Membership 2 or more employees, includes 2 members and 2 guests $200/ $25 each