Flint & Genesee Young Professionals Application First Name * Last Name * Address Line 1 Address Line 2 City State Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code Phone * Email * Employer/College Employer Address Address Line 1 Address Line 2 City State Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code Job Title/Graduation Date Why would you like to join the Young Professionals and what are you looking to offer and gain from participation? What skills/knowledge/experience can you contribute? How did you hear about the Young Professionals? Young Professionals Member Chamber Web Site A Friend My Company Other Acceptance The Young Professionals Committee of the Flint & Genesee Chamber is geared toward young professionals between the ages of 21 and 40 who want to expand their social networks, grow professionally, and make a difference in Flint & Genesee County. There are membership programs available to nonmembers. Inquire to learn more details. The Flint & Genesee Chamber reserves the right to deny or revoke membership without notice or explanation at any time. * I agree to the Flint & Genesee Chamber Committee guidelines as written. Your business/company or organization must be a good standing member with the Flint & Genesee Chamber with dues paid in full. Please provide your birthdate for verification Format: M/d/yyyy Information is optional and not required.
