Creating a Thriving Hawaii One Community at a Time

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DUANE KURISU aio Founder & Chairman of Hawai'i Executive Conference

MICAH KĀNE CEO & President Hawai'i Community Foundation

THURSDAY, AUGUST 1, 2019 Sheraton Kaua'i Resort Po'ipū Ballroom 11:00 a.m. - 1:00 p.m.

Please mail this registration form with your payment to: Kaua`i Chamber of Commerce P.O. Box 1969 Lihu`e, HI 96766 Fax to: 245-8815 Online: www.kauaichamber.org

Name: ________________________ Organization: __________________________________ Name: ________________________ Organization: __________________________________ Reservations Required: __________ X $50.00 __________ X $60.00 __________ X $70.00 __________ X $80.00 __________ X $600.00

= _____________ Young Professionals * (*must be a registered YP) = _____________ Chamber Members by July 25 = _____________ Chamber Members after July 25 = _____________ Non Members/Guests/At the Door = _____________ Table of ten

(Please provide names when purchasing tables.)

(Total) = _____________ More info call: 245-7363 No Refunds or Cancellations after July 25, 2019 (All no shows will be billed)

Method of Payment:

 MasterCard  Visa

 Check

 Cash

Credit Card Number: ____________________________________ Exp: _____ / ______ Cardholder Name ________________________________________________________ Phone #: __________________ Email: _______________________________________


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