Application

Become a member today and enjoy the benefits of our powerful group of women.

Yearly Membership Fees:
Trailblazer - Professional: $100.00
Pioneer - 65 years young: $60.00
Student - $50.00

For further questions, please contact Nina Anderson, Vice President, Membership at 303-872-9841 or winewithnina@yahoo.com.

Full Name *
Company Name *
Title
Home Address *
Work Address
Home Phone *
Work Phone *
Mobile Phone
Fax
E-Mail *
Website
Primary Business Category *
Secondary Business Category
Description of my business (90 words or less) *
How did you hear about CBW?

Who Referred You?
Are you interested in becoming a luncheon sponsor to spotlight your business?    Yes   No
Are you a * New Member    Renewing Member    Transferring Member   
Please indicate your membership level *
Trailblazer (prof) $100    Pioneer (over 65) $60    Student ($50)   

Wednesday, September 8
11:00 am - 1:00 pm

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