Credit Card - A S I A I N A

ASIAINA's
1st DIVERSITY CULTURAL FEST
& SMALL BUSINESS MIXER

November 12, 2022
Saturday | 2:00 – 8:00 PM

1001 N. BRAND BLVD., GLENDALE CA 91202

REGISTER HERE WITH VISA, MASTER, AMEX, DISCOVER CARD

Name(Required)

First Last

Phone(Required)

Email(Required)

Business Name or Organization

Business or Organization Website

How Did You Hear About Us(Required)

ASIAINA Members

Family & Friends

Local Events

Social Media or Website

Diverse Minority (DM) Collaborator(Required)

Minority Owned Business

Minority Group Affiliation

Minority Brand/Affiliate

N/A

Address

Street Address City State ZIP Code

Full Package- Membership + Small Business Mixer

Price: $125.00

This is a package for 1-year renewable membership fee, autographed book, light meals & free entrance to event.

Annual Membership Only

Price: $75.00

This is for i-year new annual ASIAINA membership fee plus a free autographed book. (No meals) & Free Entrance

Pre-Paid Member Or DM Collaborator

Price: $50.00

Additional $50 for meals for pre-paid members & diverse minority collaborators. Or small business mixer attendees only.

Total

Credit Card

Card Details

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