Name *

First Name

Last Name

Phone Number *

(###)

###

####

Business Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Organization Type *

For-Profit

Non-Profit

Information Confirmation *

I attest that I am a business owner, manager or director whose business is either located in Little Compton, RI or services the Little Compton community as a primary market for my business. I understand that my association with this group is incumbent on my active participation in the group’s meetings and programs. Additionally, I am committed to fair and ethical business practices. I am committed to building productive relationships with other member businesses. I am aware that membership in this group is at the discretion of the program leads and I can be removed at any time.

I affirm that the information I have provided is accurate and give permission for this information to be shared with other members and included on the LCBON’s public website.